天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (9): 881-885.doi: 10.11958/20193060

• 药物临床观察 • 上一篇    下一篇

苦碟子联合低分子肝素预防老年下肢骨折患者术后下肢深静脉血栓的疗效探讨

焦甲勋1，朱小丽2，索娜1，靳宪辉1△，张庆胜1，崔胜杰1   

  1. 1河北衡水，哈励逊国际和平医院骨外科（邮编053000），2药学部
  • 收稿日期:2019-10-15 修回日期:2020-06-05 出版日期:2020-09-15 发布日期:2020-09-22
  • 通讯作者: 焦甲勋 E-mail:54744005@qq.com
  • 基金资助:
    2018年度河北省医学科学研究重点课题计划（20181585）

The efficacy of Kudiezi combined with low molecular weight heparin on preventing deep venous thrombosis after operation of lower limb fracture 

JIAO Jia-xun1, ZHU Xiao-li2, SUO Na1, JIN Xian-hui1△, ZHANG Qing-sheng1, CUI Sheng-jie1   

  1. 1 Department of Spine Surgery, 2 Department of Pharmacy, Harrison International Peace Hospital, Hengshui 053000, China
  • Received:2019-10-15 Revised:2020-06-05 Published:2020-09-15 Online:2020-09-22

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摘要： 摘要：目的　探讨苦碟子注射液联合低分子肝素预防老年下肢骨折术后下肢深静脉血栓（DVT）形成的疗效。方法　选取老年（≥60岁）下肢骨折患者120例，按随机数字表法分为对照组（n=58）和试验组（n=62）。对照组术后12 h给予低分子肝素，试验组术后12 h给予苦碟子注射液联合低分子肝素。比较2组术前、术后7 d的血液流变学指标（全血高切黏度、全血低切黏度、血浆黏度）、D-二聚体、凝血功能（凝血酶原时间、活化部分凝血活酶时间）及炎性因子（肿瘤坏死因子-α、白细胞介素-6、白细胞介素-8）变化情况。采用数字疼痛量表法记录术后1、3、5、7 d疼痛评分。测量术前、术后3 d、7 d患肢与健肢大腿及小腿周径差。随访30 d内DVT发生率及不良反应发生率。结果　2组术前各指标比较差异均无统计学意义（P＞0.05）。术后7 d，试验组较对照组血液流变学、D-二聚体、炎性因子均降低（P＜0.05），2组凝血功能差异无统计学意义（P＞0.05）。术后3、5、7 d，试验组较对照组疼痛评分均降低（P＜0.01）。术后7 d，试验组较对照组患肢与健肢大腿及小腿周径差均减小（P＜0.01）。试验组DVT发生率低于对照组（3.23% vs. 13.79%，P＜0.05），不良反应发生率差异无统计学意义（4.84% vs. 3.45%，P＞0.05）。结论　苦碟子注射液联合低分子肝素能够降低老年下肢骨折患者术后血液流变学及炎性因子水平，减轻患者疼痛及患肢肿胀，减少DVT发生。
关键词：肝素，低分子量；骨折；下肢；静脉血栓形成；老年人；苦碟子注射液

关键词: 肝素, 低分子量；骨折；下肢；静脉血栓形成；老年人；苦碟子注射液

Abstract: Abstract： Objective　To study the efficacy of Kudiezi injection plus low molecular weight heparin (LMWH) on preventing deep venous thrombosis (DVT) in elderly patients with lower limb fracture surgery. Methods　Totally 120 senile patients (≥60 years old) with lower limb fracture were randomly divided into control group (CG, n=58) and treatment group (TG, n = 62). CG was received LMWH 12 h after surgery. TG was given Kudiezi injection and LMWH. Data of hemorheology (whole high blood viscosity, whole low blood viscosity and plasma viscosity), D-dimer, coagulation function (prothrombin time, activated partial thromboplastin time) and inflammatory factors (tumor necrosis factor-α, interleukin-6, interleukin-8) before surgery and 7 days after surgery were compared between CG and TG. Pain scores of 1, 3, 5 and 7 days postoperatively were recorded with numerical rating scale in two groups. Circumference differences of fracture and healthy thigh and shank were measured before surgery and 3 and 7 days after surgery. Incidences of DVT and adverse reactions within 30 days were followed up. Results No significant differences were observed in preoperative indexes between the two groups (P＞0.05). Data of hemorheology, D-dimer, coagulation function and inflammatory factors were decreased 7 days after surgery in TG versus CG (P＜0.05), and no significant differences in coagulation index were found between the two groups (P＞0.05). Pain scores of 3, 5 and 7 days after surgery were decreased in TG compared with those in CG (P＜0.01). Differences in circumference of fracture and healthy thigh and shank were lower 7 days after surgery in TG than those in CG (P＜0.01). The incidence of DVT was lower in TG (3.23%) than that of CG (13.79%, P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (4.84% and 3.45%, P＞0.05). Conclusion Kudiezi injection combined with LMWH can decrease the postoperative levels of hemorheology and inflammatory factors, alleviate pain and swelling of affected extremity, and reduce the incidence of DVT in elderly patients with lower limb fracture.

Key words: heparin, low-molecular-weight, fracture, lower limb, venous thrombosis, aged, Kudiezi Injection

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