低分子肝素钙联合血栓通治疗急性下肢深静脉血栓的疗效观察
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摘要
目的:研究低分子肝素钙联合血栓通治疗急性下肢深静脉血栓的临床疗效。方法:182例进行急性下肢深静脉血栓患者按数字表法随机分为对照组(91例)和观察组(91例)。对照组患者采用低分子肝素钙治疗,观察组患者采用低分子肝素钙联合血栓通治疗。对比两组患者治疗后的临床效果,治疗前后PT、APTT、PLT水平及血液流变学,治疗后并发症情况。结果:观察组治疗后1 d的PT(12.10±2.15)s、APTT(13.29±2.28)s高于对照组1 d的PT(11.19±2.15)s、APTT(12.26±3.12)s,3 d的PT(39.54±3.42)s、APTT(45.12±3.52)s高于对照组3 d的PT(37.43±3.12)s、APTT(39.13±3.12)s,差异具有统计学意义(P<0.05)。观察组的患者总有效率(92.31%)高于对照组的总有效率(75.82%),差异具有统计学意义(P<0.05)。治疗后,观察组的全血比高切黏度(4.52±1.03)mpa/s,全血比低切黏度(5.04±1.02)mpa/s,血浆比黏度(0.95±0.09)mpa/s明显低于对照组(5.43±0.95)mpa/s、(7.80±1.10)mpa/s、(1.47±0.11)mpa/s,差异有统计学意义(P<0.05)。结论:急性下肢深静脉血栓患者给予低分子肝素钙联合血栓通治疗临床效果比较显著,改善患者的PT、APTT、PLT水平,降低血液黏稠度,并发症低,安全可靠。
Objective: To study the clinical efficacy of low molecular weight heparin calcium combined with Xueshuantong in the treatment of acute deep venous thrombosis of lower extremities. Methods: A total of 182 patients with acute deep venous thrombosis in the lower extremities were randomly divided into the control group(91 cases) and the observation group(91 cases) according to the digital table method. The control group was treated with low molecular heparin calcium, while the observation group was treated with low molecular heparin calcium combined with Xueshuantong. The clinical effects of the two groups were compared. The levels of PT, APTT, PLT and hemorrheology before and after treatment and the complications after treatment were compared. Results: After 1 d treatment, PT(12.10±2.15)s and APTT(13.29±2.28)s of the observation group were higher than the control group's PT(11.19±2.15)s and APTT(12.26±3.12)s. After 3 d treatment,PT(39.54±3.42)s and APTT(45.12±3.52)s of the observation group were higher than the control group's PT(37.43±3.12)s and APTT(39.13±3.12)s and the difference was statistically significant(P<0.05). The total effective rate of the observation group(92.31%) was higher than the control group's(75.82%). After treatment, the high tangential viscosity(4.52±1.03)mpa/s, low shear viscosity(5.04±1.02)mpa/s and plasma viscosity(0.95±0.09)mpa/s in the observation group were significantly lower than the control group's high tangential viscosity(5.43±0.95)mpa/s, low shear viscosity(7.80±1.10)mpa/s and plasma viscosity(1.47±0.11)mpa/s(P<0.05). Conclusion: The clinical effect of low molecular weight heparin calcium combined with Xueshuangtong for acute deep venous thrombosis of lower extremities is significant. It can improve the levels of PT, APTT and PLT, reduce the viscosity of blood, lower the complication and be safe and reliable.
Objective: To study the clinical efficacy of low molecular weight heparin calcium combined with Xueshuantong in the treatment of acute deep venous thrombosis of lower extremities. Methods: A total of 182 patients with acute deep venous thrombosis in the lower extremities were randomly divided into the control group(91 cases) and the observation group(91 cases) according to the digital table method. The control group was treated with low molecular heparin calcium, while the observation group was treated with low molecular heparin calcium combined with Xueshuantong. The clinical effects of the two groups were compared. The levels of PT, APTT, PLT and hemorrheology before and after treatment and the complications after treatment were compared. Results: After 1 d treatment, PT(12.10±2.15)s and APTT(13.29±2.28)s of the observation group were higher than the control group's PT(11.19±2.15)s and APTT(12.26±3.12)s. After 3 d treatment,PT(39.54±3.42)s and APTT(45.12±3.52)s of the observation group were higher than the control group's PT(37.43±3.12)s and APTT(39.13±3.12)s and the difference was statistically significant(P<0.05). The total effective rate of the observation group(92.31%) was higher than the control group's(75.82%). After treatment, the high tangential viscosity(4.52±1.03)mpa/s, low shear viscosity(5.04±1.02)mpa/s and plasma viscosity(0.95±0.09)mpa/s in the observation group were significantly lower than the control group's high tangential viscosity(5.43±0.95)mpa/s, low shear viscosity(7.80±1.10)mpa/s and plasma viscosity(1.47±0.11)mpa/s(P<0.05). Conclusion: The clinical effect of low molecular weight heparin calcium combined with Xueshuangtong for acute deep venous thrombosis of lower extremities is significant. It can improve the levels of PT, APTT and PLT, reduce the viscosity of blood, lower the complication and be safe and reliable.
引文
[1] 田玲.集束化干预在预防剖宫产术后患者下肢深静脉血栓形成的临床研究[J].辽宁医学杂志,2016,30(3):43-44.
[2] 李正,樊立宏,董炜,等.血栓通注射液联合利伐沙班预防下肢骨折术后下肢深静脉血栓形成疗效及对患者血液流变学的影响[J].现代生物医学进展,2017,17(21):4175-4178.
[3] Gonda DD,Fridley J,Ryan SL,et al.The safety and efficacy of use of low-molecular-weight heparin in pediatric neurosurgical patients[J].J Neurosurg Pediatr,2015,16(3):329-334.
[4] 祝建勇,张斌剑,王鹏斌.利伐沙班、低分子肝素联合足底泵治疗髋关节置换术后深静脉血栓的疗效分析[J].陕西医学杂志,2017,46(8):1126-1127.
[5] 王文岳,谢利民,宋康康,等.益气通脉方与低分子肝素预防髋部大手术下肢深静脉血栓的随机对照研究[J].中国中医骨伤科杂志,2016,24(11):15-18,23.
[6] 李建鹏,王峥.血栓通联合前列地尔治疗下肢动脉硬化闭塞症的有效性及对其血液流变学的影响[J].中国实验方剂学杂志,2016,22(6):159-162.
[7] Thomas O,Lybeck E,Strandberg K,et al.Monitoring low molecular weight heparins at therapeutic levels:dose-responses of and correlations and differences between aPTT anti-factor Xa and thrombin generation assays[J].PLoS One,2015,10(1):e116835.
[8] 初丽敏,黄芩,魏树林,等.曲美他嗪联合血栓通对老年下肢动脉硬化闭塞症患者的疗效观察[J].中国医药导刊,2016,18(6):604-606.
[9] 王瑜琦,喻萍,涂小玲,等.空气压力波辅助血栓通、抗血小板治疗对脑卒中后下肢偏瘫患者偏瘫症状及下肢血流的影响[J].实用医院临床杂志,2018,15(1):59-62.
[10] Kim KK,Won Y,Won YY.The Efficacy of Low Molecular Weight Heparin for the Prevention of Venous Thromboembolism after Hip Fracture Surgery in Korean Patients[J].Yonsei Med J,2016,57(5):1209-1213.
[11] 陈丽芳,宋晓华,黄于朗.血栓通联合前列地尔对下肢动脉硬化闭塞症患者血清生化指标及预后的影响[J].中国慢性病预防与控制,2017,25(10):765-768.
[12] 刘辉,卢辉俊.尿激酶分别联合阿加曲班和低分子肝素治疗下肢深静脉血栓疗效的对比研究[J].贵州医药,2016,40(11):1167-1169.
[13] 黄永栋,蒋卫平,赵辉,等.利伐沙班和低分子肝素钙预防老年股骨粗隆间骨折术后深静脉血栓形成的效果比较[J].中国骨与关节损伤杂志,2016,31(2):134-137.
[14] Shirasugi N,Horiguchi S,Shirato H,et al.Prevalence of Isolated Asymptomatic Deep Vein Thrombosis in Varicose Vein Patients with Superficial Thrombophlebitis:A Single Center Experience in Japan[J].Ann Vasc Dis,2016,9(1):2-7.
[15] 葸根,陆雄.低分子肝素钙预防下肢静脉曲张术后深静脉血栓的价值[J].中国普通外科杂志,2016,25(12):1806-1810.
[16] 彭凤,杨敏,杨红胜,等.低分子肝素钠联合红花注射液预防下肢骨折术后深静脉血栓形成的临床效果[J].西部医学,2017,29(8):1085-1087,1091.
[17] Squizzato A,Lussana F,Cattaneo M.Post-operative arterial thrombosis with non-vitamin K antagonist oral anticoagulants after total hip or knee arthroplasty[J].Thrombo Haemost,2015,114(2):237.
[18] 罗彩娥.低分子肝素预防老年髋关节周围骨折患者围术期下肢深静脉血栓的效果[J].实用临床医药杂志,2017,21(13):218-221.
[19] 邢贞武,余德涛,邢祯全,等.利伐沙班与低分子肝素钙预防全髋关节置换术后深静脉血栓的效果比较[J].中国药房,2017,28(23):3247-3250.
[20] 黄润强,郭振鹏,袁修琼,等.低分子肝素钙在妇科肿瘤腹腔镜术后预防深静脉血栓中的临床效果[J].现代肿瘤医学,2017,25(3):444-447.
[21] Forster R,Stewart M.Anticoagulants(extended duration)for prevention of venous thromboembolism following total hip or knee replacement or hip fractu rerepair[J].Cochrane Database Syst Rev,2016,30(3):CD004179.
[22] 王艺伟,石岩,李斌,等.腰椎手术患者术后应用利伐沙班和低分子肝素对凝血功能变化和深静脉血栓的预防作用对比[J].临床和实验医学杂志,2018,17(2):180-182.
[23] 杨国凯,杨镛,万嘉,等.阿加曲班与低分子肝素钙在急性下肢深静脉血栓治疗中的对比观察[J].贵州医药,2018,42(1):57-59.
[2] 李正,樊立宏,董炜,等.血栓通注射液联合利伐沙班预防下肢骨折术后下肢深静脉血栓形成疗效及对患者血液流变学的影响[J].现代生物医学进展,2017,17(21):4175-4178.
[3] Gonda DD,Fridley J,Ryan SL,et al.The safety and efficacy of use of low-molecular-weight heparin in pediatric neurosurgical patients[J].J Neurosurg Pediatr,2015,16(3):329-334.
[4] 祝建勇,张斌剑,王鹏斌.利伐沙班、低分子肝素联合足底泵治疗髋关节置换术后深静脉血栓的疗效分析[J].陕西医学杂志,2017,46(8):1126-1127.
[5] 王文岳,谢利民,宋康康,等.益气通脉方与低分子肝素预防髋部大手术下肢深静脉血栓的随机对照研究[J].中国中医骨伤科杂志,2016,24(11):15-18,23.
[6] 李建鹏,王峥.血栓通联合前列地尔治疗下肢动脉硬化闭塞症的有效性及对其血液流变学的影响[J].中国实验方剂学杂志,2016,22(6):159-162.
[7] Thomas O,Lybeck E,Strandberg K,et al.Monitoring low molecular weight heparins at therapeutic levels:dose-responses of and correlations and differences between aPTT anti-factor Xa and thrombin generation assays[J].PLoS One,2015,10(1):e116835.
[8] 初丽敏,黄芩,魏树林,等.曲美他嗪联合血栓通对老年下肢动脉硬化闭塞症患者的疗效观察[J].中国医药导刊,2016,18(6):604-606.
[9] 王瑜琦,喻萍,涂小玲,等.空气压力波辅助血栓通、抗血小板治疗对脑卒中后下肢偏瘫患者偏瘫症状及下肢血流的影响[J].实用医院临床杂志,2018,15(1):59-62.
[10] Kim KK,Won Y,Won YY.The Efficacy of Low Molecular Weight Heparin for the Prevention of Venous Thromboembolism after Hip Fracture Surgery in Korean Patients[J].Yonsei Med J,2016,57(5):1209-1213.
[11] 陈丽芳,宋晓华,黄于朗.血栓通联合前列地尔对下肢动脉硬化闭塞症患者血清生化指标及预后的影响[J].中国慢性病预防与控制,2017,25(10):765-768.
[12] 刘辉,卢辉俊.尿激酶分别联合阿加曲班和低分子肝素治疗下肢深静脉血栓疗效的对比研究[J].贵州医药,2016,40(11):1167-1169.
[13] 黄永栋,蒋卫平,赵辉,等.利伐沙班和低分子肝素钙预防老年股骨粗隆间骨折术后深静脉血栓形成的效果比较[J].中国骨与关节损伤杂志,2016,31(2):134-137.
[14] Shirasugi N,Horiguchi S,Shirato H,et al.Prevalence of Isolated Asymptomatic Deep Vein Thrombosis in Varicose Vein Patients with Superficial Thrombophlebitis:A Single Center Experience in Japan[J].Ann Vasc Dis,2016,9(1):2-7.
[15] 葸根,陆雄.低分子肝素钙预防下肢静脉曲张术后深静脉血栓的价值[J].中国普通外科杂志,2016,25(12):1806-1810.
[16] 彭凤,杨敏,杨红胜,等.低分子肝素钠联合红花注射液预防下肢骨折术后深静脉血栓形成的临床效果[J].西部医学,2017,29(8):1085-1087,1091.
[17] Squizzato A,Lussana F,Cattaneo M.Post-operative arterial thrombosis with non-vitamin K antagonist oral anticoagulants after total hip or knee arthroplasty[J].Thrombo Haemost,2015,114(2):237.
[18] 罗彩娥.低分子肝素预防老年髋关节周围骨折患者围术期下肢深静脉血栓的效果[J].实用临床医药杂志,2017,21(13):218-221.
[19] 邢贞武,余德涛,邢祯全,等.利伐沙班与低分子肝素钙预防全髋关节置换术后深静脉血栓的效果比较[J].中国药房,2017,28(23):3247-3250.
[20] 黄润强,郭振鹏,袁修琼,等.低分子肝素钙在妇科肿瘤腹腔镜术后预防深静脉血栓中的临床效果[J].现代肿瘤医学,2017,25(3):444-447.
[21] Forster R,Stewart M.Anticoagulants(extended duration)for prevention of venous thromboembolism following total hip or knee replacement or hip fractu rerepair[J].Cochrane Database Syst Rev,2016,30(3):CD004179.
[22] 王艺伟,石岩,李斌,等.腰椎手术患者术后应用利伐沙班和低分子肝素对凝血功能变化和深静脉血栓的预防作用对比[J].临床和实验医学杂志,2018,17(2):180-182.
[23] 杨国凯,杨镛,万嘉,等.阿加曲班与低分子肝素钙在急性下肢深静脉血栓治疗中的对比观察[J].贵州医药,2018,42(1):57-59.
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