髋关节置换术后联合丹参川芎嗪治疗对老年患者认知功能、凝血功能及下肢深静脉血栓的影响
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摘要
目的观察髋关节置换术后联合丹参川芎嗪治疗对老年患者认知功能、凝血功能及下肢深静脉血栓的影响。方法随机选取2017年1月至2018年6月接受髋关节置换术的112例老年患者(≥60岁)为研究对象,应用随机抽签法均分为两组,每组56例。对照组术后给予常规治疗,观察组常规治疗基础上予以丹参川芎嗪。比较治疗2周两组患者凝血功能、认知功能及下肢深静脉血栓形成(DVT)情况。结果治疗2周后,观察组血小板聚集率、血沉、纤维蛋白原水平、血浆黏度、红细胞压积、全血高切黏度以及全血低切黏度、静脉瘀滞指数均低于对照组(P<0.05),观察组凝血酶原时间、凝血酶原时间长于对照组(P<0.05);观察组MMSE评分高于对照组(P<0.05),观察组下肢DVT发生率(3.57%)低于对照组(17.86%)(P<0.05)。结论丹参川芎嗪可有效提高老年患者髋关节置换术后认知功能,改善脑血管供血,降低血液黏度,减小下肢深静脉血栓形成风险。
Objective To observe the effect of the combination of salvia miltiorrhiza ligustrazine and hip arthroplasty on the cognitive function,coagulation function and the incidence of deep venous thrombosis in the lower extremity.Methods A total of 112 elderly patients(over 60 years old)undergoing hip replacement from January 2017 to June 2018 were selected as subjects,and they were randomly divided into two groups,with 56 patients in each group.In the control group,the routine treatment was given,and the observation group was treated with salvia miltiorrhiza ligustrazine on the basis of routine treatment.The coagulation function,cognitive function and deep venous thrombosis(DVT) of lower extremities were compared with those of the two groups in 2 weeks after operation.Results After 2 weeks of treatment,platelet aggregation rate,ESR,FIB,plasma viscosity,hematocrit,whole blood high shear viscosity,whole blood low shear viscosity and SI in the observation group were significantly lower than those in the control group(P<0.05).The levels of PT and APTT in the observation group were longer than those of the control group(P<0.05),and the MMSE score of the observation group was higher than that of the control group(P<0.05).The incidence of lower limb DVT in the observation group was significantly lower than that in the control group(3.57% vs 17.86%)(P<0.05).Conclusions Salvia miltiorrhiza Ligustrazine can effectively improve the cognitive function of senile patients after hip arthroplasty,improve cerebrovascular blood supply,reduce blood viscosity,and reduce the risk of deep venous thrombosis of lower extremities.
Objective To observe the effect of the combination of salvia miltiorrhiza ligustrazine and hip arthroplasty on the cognitive function,coagulation function and the incidence of deep venous thrombosis in the lower extremity.Methods A total of 112 elderly patients(over 60 years old)undergoing hip replacement from January 2017 to June 2018 were selected as subjects,and they were randomly divided into two groups,with 56 patients in each group.In the control group,the routine treatment was given,and the observation group was treated with salvia miltiorrhiza ligustrazine on the basis of routine treatment.The coagulation function,cognitive function and deep venous thrombosis(DVT) of lower extremities were compared with those of the two groups in 2 weeks after operation.Results After 2 weeks of treatment,platelet aggregation rate,ESR,FIB,plasma viscosity,hematocrit,whole blood high shear viscosity,whole blood low shear viscosity and SI in the observation group were significantly lower than those in the control group(P<0.05).The levels of PT and APTT in the observation group were longer than those of the control group(P<0.05),and the MMSE score of the observation group was higher than that of the control group(P<0.05).The incidence of lower limb DVT in the observation group was significantly lower than that in the control group(3.57% vs 17.86%)(P<0.05).Conclusions Salvia miltiorrhiza Ligustrazine can effectively improve the cognitive function of senile patients after hip arthroplasty,improve cerebrovascular blood supply,reduce blood viscosity,and reduce the risk of deep venous thrombosis of lower extremities.
引文
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[8]陈贞君,方嘉阳,邱星颖,等.丹参川芎嗪注射液联合盐酸氟桂利嗪预防下肢骨折术后长期卧床患者阵发性位置性眩晕及下肢深静脉血栓的临床观察[J].中国药房,2016,27(17):2385-2387.DOI:10.6039/j.issn.1001-0408.2016.17.27.
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[10]张杰,陈平,荣冬明,等.人工关节置换术后并发深静脉血栓形成的危险因素评估[J].中国矫形外科杂志,2016,24(11):1001-1005.DOI:10.3977/j.issn.1005-8478.2016.11.09.
[11]何学军,范朝铭.老年髋关节置换术致深静脉血栓60例影响因素分析[J].陕西医学杂志,2016,45(5):591-592.DOI:10.3969/j.issn.1000-7377.2016.05.035.
[12]李琳,何丽英,田艳茶,等.护理干预对髋关节置换术后深静脉血栓形成的影响[J].河北医科大学学报,2016,37(1):75-77.DOI:10.3969/j.issn.1007-3205.2016.01.022.
[13]郄晓娟,郑文婧,董江龙,等.老年患者髋关节置换术后认知功能障碍的危险因素分析[J].广东医学,2016,37(10):1488-1491.
[14]张丛林.血栓通联合丹参川芎嗪治疗椎-基底动脉供血不足性眩晕的疗效及对血液流变学的影响[J].河北医药,2017,39(1):127-129.DOI:10.3969/j.issn.1002-7386.2017.01.040.
[15]徐春林,熊学辉,吴雅兰,等.丹参川芎嗪联合长春西汀治疗颅脑损伤后遗症的临床研究[J].湖南中医药大学学报,2017,37(8):910-912.DOI:10.3969/j.issn.1674-070X.2017.08.023.
[16]张楠,张洋.冰黄散外敷护理联合丹参川芎嗪注射液治疗骨科术后下肢深静脉血栓形成[J].长春中医药大学学报,2018,34(1):139-141.DOI:10.13463/j.cnki.cczyy.2018.01.045.
[2]Audenaert T,Allaert S,Sutter JD.An elderly patient with non-corrected interruption of the aortic arch in need of total hip replacement:role of preoperative imaging[J].Int J Cardiovasc Imaging,2016,32(3):479.DOI:10.1007/s10554-015-0784-x.
[3]卢中莲.丹参川芎嗪注射液联合低分子肝素治疗后循环缺血疗效观察[J].陕西中医,2017,38(7):846-848.DOI:10.3969/j.issn.1000-7369.2017.07.016.
[4]郑勇,马木提江,秦承东,等.丹参川芎嗪与低分子肝素预防下肢骨折术后深静脉血栓形成疗效观察[J].世界中西医结合杂志,2014,9(9):967-969.DOI:10.13935/j.cnki.sjzx.140919.
[5]邹林汝,谭开彬,高云华,等.静脉瘀滞指数对关节置换术后下肢深静脉血栓风险的评估[J].中国超声医学杂志,2015,31(11):1032-1034.
[6]陈一帆.中西医结合防治髋关节置换术后下肢深静脉血栓形成的临床观察[J].中医临床研究,2013,5(20):59-60.DOI:10.3969/j.issn.1674-7860.2013.20.033.
[7]彭宗生,许超,魏芳,等.丹参川芎嗪注射液预防股骨近端骨折患者术后DVT效果观察[J].山东医药,2016,56(16):70-72.DOI:10.3969/j.issn.1002-266X.2016.16.026.
[8]陈贞君,方嘉阳,邱星颖,等.丹参川芎嗪注射液联合盐酸氟桂利嗪预防下肢骨折术后长期卧床患者阵发性位置性眩晕及下肢深静脉血栓的临床观察[J].中国药房,2016,27(17):2385-2387.DOI:10.6039/j.issn.1001-0408.2016.17.27.
[9]Zhang C,Xu B,Liang G,et al.Rivaroxaban versus nadroparin for preventing deep venous thrombosis after total hip arthroplasty following femoral neck fractures:a retrospective comparative study[J].J In Med Res,2018,46(5):1936-1946.DOI:10.1177/0300060518762281.
[10]张杰,陈平,荣冬明,等.人工关节置换术后并发深静脉血栓形成的危险因素评估[J].中国矫形外科杂志,2016,24(11):1001-1005.DOI:10.3977/j.issn.1005-8478.2016.11.09.
[11]何学军,范朝铭.老年髋关节置换术致深静脉血栓60例影响因素分析[J].陕西医学杂志,2016,45(5):591-592.DOI:10.3969/j.issn.1000-7377.2016.05.035.
[12]李琳,何丽英,田艳茶,等.护理干预对髋关节置换术后深静脉血栓形成的影响[J].河北医科大学学报,2016,37(1):75-77.DOI:10.3969/j.issn.1007-3205.2016.01.022.
[13]郄晓娟,郑文婧,董江龙,等.老年患者髋关节置换术后认知功能障碍的危险因素分析[J].广东医学,2016,37(10):1488-1491.
[14]张丛林.血栓通联合丹参川芎嗪治疗椎-基底动脉供血不足性眩晕的疗效及对血液流变学的影响[J].河北医药,2017,39(1):127-129.DOI:10.3969/j.issn.1002-7386.2017.01.040.
[15]徐春林,熊学辉,吴雅兰,等.丹参川芎嗪联合长春西汀治疗颅脑损伤后遗症的临床研究[J].湖南中医药大学学报,2017,37(8):910-912.DOI:10.3969/j.issn.1674-070X.2017.08.023.
[16]张楠,张洋.冰黄散外敷护理联合丹参川芎嗪注射液治疗骨科术后下肢深静脉血栓形成[J].长春中医药大学学报,2018,34(1):139-141.DOI:10.13463/j.cnki.cczyy.2018.01.045.