补肾祛瘀汤联合利伐沙班对膝关节置换术患者术后深静脉血栓的预防作用  

Preventive Effect of Bushen Quyu Decoction Combined with Rivaroxaban on Deep Vein Thrombosis in Patients After Knee Arthroplasty

作　　者：许金珠 吴仁政 张志远 XU Jinzhu;WU Renzheng;ZHANG Zhiyuan(Department of Hip and Knee Joint Surgery,Dongyang Garden Tian's Hospital,Dongyang Zhejiang 322121,China)

机构地区：[1]东阳花园田氏医院髋膝关节外科,浙江东阳322121

出　　处：《新中医》2024年第9期93-97,共5页New Chinese Medicine

摘　　要：目的:观察补肾祛瘀汤联合利伐沙班对膝关节置换术患者术后深静脉血栓(DVT)的预防作用。方法:选择接受全膝关节置换术治疗的患者126例,按随机数字表法分为观察组和对照组各63例。对照组术后给予利伐沙班片口服,观察组在对照组基础上给予补肾祛瘀汤治疗。比较2组术后DVT发生率,术后下肢周径差、血液流变学指标、凝血指标、血清炎症因子变化以及不良反应发生率。结果:术后14 d,观察组DVT发生率为3.17%,低于对照组14.29%(P<0.05)。术后14 d,2组大腿周径差以及小腿周径差均较术后1 d降低(P<0.05),且术后14 d观察组大腿周径差以及小腿周径差均低于对照组(P<0.05)。术后14 d,2组全血高切黏度、红细胞压积、血浆黏度以及血小板黏附率各指标均较术后1 d降低(P<0.05);且术后14 d,观察组全血高切黏度、红细胞压积、血浆黏度以及血小板黏附率低于对照组(P<0.05)。术后14 d,2组凝血酶时间(TT)、活化部分凝血酶时间(APTT)较术后1 d升高(P<0.05),D-二聚体(D-D)以及纤维蛋白原(FIB)水平较术后1 d降低(P<0.05);且术后14 d,观察组TT、APTT高于对照组(P<0.05),D-D以及FIB低于对照组(P<0.05)。术后14 d,2组血清白细胞介素-8 (IL-8)、C-反应蛋白(CRP)以及肿瘤坏死因子-α (TNF-α)均较术后1 d降低(P<0.05);且术后14 d,观察组血清IL-8、CRP以及TNF-α低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:补肾祛瘀汤联合利伐沙班可有效预防膝关节置换术患者术后DVT的形成,其作用可能与改善患者术后血液高凝状态及炎症反应有关,治疗安全性高。Objective:To observe the preventive effect of Bushen Quyu Decoction combined with Rivaroxaban on deep vein thrombosis(DVT)in patients after knee arthroplasty.Methods:A total of 126 cases of patients receiving total knee arthroplasty were divided into the observation group and the control group according to the random number table method,with 63 cases in each group.After surgery,the control group was given the oral administration of Rivaroxaban,and the observation group was additionally treated with Bushen Quyu Decoction based on the treatment of the control group.The incidence of postoperative DVT,the changes in postoperative peripheral diameter difference of lower limbs,hemorheology indexes,coagulation indexes,and serum inflammatory factors,and the incidence of adverse reactions were compared between the two groups. Results: On the day 14 after surgery, theincidence of DVT was 3.17% in the observation group,lower than that of 14.29% in the control group (P<0.05). On the day 14 after surgery,the circumference differences of thighs and legs in the two groups weredecreased when compared with those on the day 1 after surgery (P<0.05), and the circumferencedifferences of thighs and legs in the observation group were lower than those in the control group on the day14 after surgery (P<0.05). On the day 14 after surgery,the indexes of whole blood high-shear viscosity,hematocrit, plasma viscosity and platelet adhesion rates in the two groups were decreased whencompared with those on the day 1 after surgery (P<0.05);the indexes of whole blood high-shear viscosity,hematocrit,plasma viscosity and platelet adhesion rate in the observation group were lower than those inthe control group (P<0.05). On the day 14 after surgery,thrombin time (TT) and activated partial thrombintime (APTT) in the two groups were increased when compared with those on the day 1 after surgery (P<0.05),and the levels of D-dimer (D-D) and fibrinogen (FIB) were decreased when compared with those onthe day 1 after surgery (P<0.05);on the day 14 after surg

关 键 词：膝关节置换术 深静脉血栓 补肾祛瘀汤 利伐沙班 预防作用 凝血功能 炎症因子 

分 类 号：R687.4[医药卫生—骨科学]