脉络舒通联合低分子肝素预防下肢深静脉血栓的疗效观察

Efficacy and safety of the low molecular weight heparin and mailuoshutong to prevent deep venous thrombosis

目的观察脉络舒通颗粒联合低分子肝素预防全膝、髋关节置换术后下肢深静脉血栓(deep venous thrombosis,DVT)形成的效果和安全性。方法2006年6月至2009年8月航空工业中心医院和北京中日友好医院收治88例全髋和85例全膝关节置换患者,随机分为实验组和对照组,患者术后应用硬膜外止痛泵止痛。实验组患者术后第1天口服脉络舒通颗粒,拔硬膜外泵后12小时后(术后3天)应用低分子肝素预防DVT发生。对照组患者术后3天应用低分子肝素预防DVT发生。结果实验组患者DVT发生率为3.3%(3/91),对照组患者DVT发生率为11.0%(9/82),前者低于后者,两组差异有统计学意义(χ2=3.940,P<0.05)。实验组患者出血副反应的发生率为6.6%(6/91),对照组患者为6.1%(5/82),两者差异无统计学意义(χ2=0.018,P>0.05)。结论对全髋、膝关节置换术后应用止痛泵患者,术后应用脉络舒通颗粒联合术后3天应用低分子肝素预防DVT效果可靠、安全性高。

Objective To Observe the efficacy and safety of with mailuoshutong and low molecular weight heparin to prevent lower extremity deep venous thrombosis for total knee and hip arthroplasty. Methods From June 2006 to August 2009,88 cases of total hip and 85 cases of total knee arthroplasty inpatients were randomly divided into experimental group and control group. Epidural analgesia pump was used to relieve pain after operation. In order to prevent DVT,Oral Mailuoshutong was used on the first day after operation and low molecular weight heparin on the third day after pulling epidural Pump. Low molecular weight heparin was used to prevent DVT on the third day after pulling epidural Pump. Results The incidence of DVT for patients in experimental group was 3.3%（3/91）. The incidence of DVT for patients in control group was 11.0%（9/82）. There was significant Difference between the two groups （χ^2=3.940,P〈0.05）. The incidence of adverse reactions with bleeding in experiment patients was 6.6%,and 6.1% in control group patients. There was insignificant Difference between the two groups （χ^2=0.018,P〉0.05）. Conclusion It is safe,feasible and effective to prevent DVT for total hip and knee replacement patients,who used mailuoshutong on the first day and low molecular weight heparin on the third day after operation.