陇中消肿止痛合剂预防全髋关节置换术后深静脉血栓的临床研究

Clinical Study of Longzhong Xiaozhongzhitong Mixture on Prevention of Deep Vein Thrombosis after Total Hip Arthroplasty

目的观察陇中消肿止痛合剂预防全髋关节置换术(THA)后下肢深静脉血栓(DVT)的临床疗效。方法将行THA患者186例随机分为A组89例和B组97例。术后12 h,在一般性预防血栓措施基础上,A组皮下注射低分子肝素钙0.6 mL/次,B组口服陇中消肿止痛合剂50 mL/次,2组均2次/d,应用10 d。2组患者术前及术后行下肢彩超检查,并于术后3、7、14 d检测D-二聚体,观测2组血栓发生率、凝血指标、术后切口引流量等的变化。结果 2组患者术后共发生DVT 9例(A组4例、B组5例),B组肺栓塞死亡1例,8例治疗痊愈,185例患者平均随访3.4个月。B组下肢静脉血栓发生率与A组相当(P>0.05),2组FIB、D-二聚体较本组用药前下降(P<0.05);B组术后引流量较A组少(P<0.05)。结论陇中消肿止痛合剂对全髋关节置换术后深静脉血栓形成的预防作用与低分子肝素钙相当。

Objective To investigate the effect of Longzhong Xiaozhongzhitong mixture on prevention of deep vein thrombosis（DVT） after total hip arthroplasty.Methods A total of 186 patients with artificial total hip arthroplasty were randomly divided into group A（89 cases） and group B（97 cases）.After 12 h of surgery,on the basis of rountine measures of preventing DVT,group A received low-molecular-weight heparin calcium（LMWH） 0.6 mL by subcutaneous injection,and group B received Longzhong Xiaozhong-zhitong mixture 50 mL orally twice a day for 10 days.The colour Doppler of lower limbs were tested before and after operation,D-dimer was determined at 3,7,14 day after operation.The incidence of thrombosis,coagulation parameters,postoperative wound drainage and other changes of the two groups were analyzed.Results There were 9 cases had DVT of lower limbs in two groups（4 cases in group A and 5 cases in group B）,1 case in group B died of pulmonary embolism,8 cases were cured.The follow-ups of 185 patients averaged 3.4 months.The two groups was similar in the incidence of DVT（P〈0.05）.The value of FIB and D-dimer in two groups were both decreased respectively than before the treatment（P〈0.05）.The postoperative drainage volume of group B was less than that of group A（P〈0.05）.Conclusion Longzhong Xiaozhongzhitong mixture and LMWH therapy are equally effective in the prevention of postoperative DVT.