低相对分子质量肝素联合活血灵防治骨科大手术后深静脉血栓形成
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摘要
目的评价活血灵预防骨科大手术后深静脉血栓形成(DVT)的临床疗效。方法选择2013年4月至2014年12月来我院行骨科大手术的病人100例,根据excel表格随机数字表法随机分为两组:皮下注射低相对分子质量肝素(LMWH)组(西医组,50人)和皮下注射LMWH联合口服活血灵组(联合组,50人),分别检测患者手术后12 d血小板(PLT)凝血酶原时间(PT)活化部分凝血活酶时间(aPTT)值。在术后12 d用超声检测是否有下肢DVT的发生。根据血液流变学光学检测方式检测术前及术后12 d全血低切还原粘度、全血高切还原粘度、红细胞聚集指数,全血方程K值。结果两组术后全血低切还原粘度、全血高切还原粘度、红细胞聚集指数,全血方程K值,较术前都有所降低(P<0.05),组间比较结果显示,术后联合组的血液流变学指标较西医组低(P<0.05);联合组的aPTT值、PT值均高于西医组(P<0.05(;西医组有7人发生下肢DVT,联合组有1人,P<0.05,差异有统计学意义。结论活血灵能够有效的降低血浆粘度及延长PT和aPTT,能有效的降低骨科大手术后DVT的发病率。
Objective Evaluation of invigorate the spirit to prevent orthopaedic hand the clinical curative effect of postoperative deep vein thrombosis( DVT). Methods Choose between April 2013 and December 2013 to our line of orthopedic major surgery,100 patients with random number table method based on excel form were randomly divided into two groups: subcutaneous injection of low molecular weight heparin group( LMWH)( western medicine group,50 people) and subcutaneous injection of LMWH combined oral invigorate the spirit group( joint group,50 people), Patients after surgery was detected in 12 d platelet( PLT),prothrombin time( PT),activated partial coagulation time( aPTT). 12 d after surgery with ultrasonic testing whether there is the occurrence of DVT of lower limbs. According to the hemorheology optical detecting way in preoperative and postoperative 12 d whole blood low shear reduction viscosity,whole blood high shear reductive viscosity,erythrocyte aggregation index,whole blood equation K value. Results Two groups of postoperative whole blood low shear reduction viscosity,whole blood high shear reductive viscosity,erythrocyte aggregation index,whole blood equation K value,reduced compared with preoperative( P < 0. 05),the comparison between groups,according to the results of postoperative joint group of hemorheology index was lower than those of western medicine group( P < 0. 05); The values of aPTT and PT values of joint group were higher than that of western medicine group,( P < 0. 05); Western medicine group of seven people in lower limb deep vein thrombus( DVT), joint group were one joint group( P < 0. 05). Conclusion Invigorate the spirit can effectively reduce the blood viscosity and prolong the PT and aPTT can effectively reduce the orthopaedic hand the incidence of postoperative DVT.
Objective Evaluation of invigorate the spirit to prevent orthopaedic hand the clinical curative effect of postoperative deep vein thrombosis( DVT). Methods Choose between April 2013 and December 2013 to our line of orthopedic major surgery,100 patients with random number table method based on excel form were randomly divided into two groups: subcutaneous injection of low molecular weight heparin group( LMWH)( western medicine group,50 people) and subcutaneous injection of LMWH combined oral invigorate the spirit group( joint group,50 people), Patients after surgery was detected in 12 d platelet( PLT),prothrombin time( PT),activated partial coagulation time( aPTT). 12 d after surgery with ultrasonic testing whether there is the occurrence of DVT of lower limbs. According to the hemorheology optical detecting way in preoperative and postoperative 12 d whole blood low shear reduction viscosity,whole blood high shear reductive viscosity,erythrocyte aggregation index,whole blood equation K value. Results Two groups of postoperative whole blood low shear reduction viscosity,whole blood high shear reductive viscosity,erythrocyte aggregation index,whole blood equation K value,reduced compared with preoperative( P < 0. 05),the comparison between groups,according to the results of postoperative joint group of hemorheology index was lower than those of western medicine group( P < 0. 05); The values of aPTT and PT values of joint group were higher than that of western medicine group,( P < 0. 05); Western medicine group of seven people in lower limb deep vein thrombus( DVT), joint group were one joint group( P < 0. 05). Conclusion Invigorate the spirit can effectively reduce the blood viscosity and prolong the PT and aPTT can effectively reduce the orthopaedic hand the incidence of postoperative DVT.
引文
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[3]张延召,张宏军,范克杰,等.活血灵方预防股骨干骨折后下肢深静脉血栓形成临床观察[J].亚太传统医药,2016,8:96-97.
[4]PRANDONI P,LENSING A W,COGO A,et al.The longterm clinical course of acute deep venous thrombosis[J].Annals of Internal Medicine,1996,125(1):1-7.
[5]朱刃,魏社军,吴思旺,等.骨科大手术下肢深静脉血栓的早期诊断[J].中国修复重建外科杂志,2010,6:730-4.
[6]高福来,沈海萍,王进华,等.通脉活血灵治疗高粘血症75例[J].中国医药学报,1996,2:57.
[7]沈素红,郭艳幸,席占国,等.洛阳正骨传统方药活血灵预防骨科术后下肢深静脉血栓形成的临床研究[J].中国中医骨伤科杂志,2011,3:21-22.
[8]章丽琴,徐志文,俞北伟,等.中医药综合措施对骨科大手术后下肢深静脉血栓形成的监测和防治[J].中华中医药学刊,2015,04):993-966.
[2]贺成城.推拿配合功能锻炼预防髋部骨折术后下肢深静脉血栓形成的观察[J].中南医学科学杂志,2011,4:453-454.
[3]张延召,张宏军,范克杰,等.活血灵方预防股骨干骨折后下肢深静脉血栓形成临床观察[J].亚太传统医药,2016,8:96-97.
[4]PRANDONI P,LENSING A W,COGO A,et al.The longterm clinical course of acute deep venous thrombosis[J].Annals of Internal Medicine,1996,125(1):1-7.
[5]朱刃,魏社军,吴思旺,等.骨科大手术下肢深静脉血栓的早期诊断[J].中国修复重建外科杂志,2010,6:730-4.
[6]高福来,沈海萍,王进华,等.通脉活血灵治疗高粘血症75例[J].中国医药学报,1996,2:57.
[7]沈素红,郭艳幸,席占国,等.洛阳正骨传统方药活血灵预防骨科术后下肢深静脉血栓形成的临床研究[J].中国中医骨伤科杂志,2011,3:21-22.
[8]章丽琴,徐志文,俞北伟,等.中医药综合措施对骨科大手术后下肢深静脉血栓形成的监测和防治[J].中华中医药学刊,2015,04):993-966.