活血散瘀方联合低分子肝素钙对老年下肢大手术D-二聚体的影响分析

Analysis on the Effect of Promoting Blood Circulation for Removing Blood Stasis Prescription Combined with Low Molecular Weight Heparin Calcium on D-dimer in Elderly Lower Extremity Surgery

目的分析活血散瘀方在深静脉血栓形成防治中的价值。方法 2015年2月—2016年11月,我院骨科收治老年下肢大手术患者62例,随机数字表达法分组,对照组、观察组各31例,对照组术前1日、术后1~7日使用低分子肝素钙,观察组联合活血散瘀方,对比不同时间段D-二聚体水平,对比深静脉血栓形成、出血并发症发生情况。结果组间对比观察组术后1周、术后2周D-二聚体水平低于对照组,组内对比两组术后48h D-二聚体水平高于术前1日、术后即刻,组内对比两组术后1周、术后2周低于术后48h,差异有统计学意义(P<0.05);观察组血栓形成发生率0(0/31),对照组9.7%(3/31),差异无统计学意义(χ~2=2.41,P=0.121>0.05);观察组与对照组出血不良事件合计发生率分别为16.1%、12.9%,差异无统计学意义(χ~2=0.00,P=1.000>0.05)。结论活血散瘀方联合低分子肝素钙可降低老年下肢大手术患者术后D-二聚体水平。

Objective To analyze the value of promoting blood circulation for removing blood stasis prescription in the prevention and treatment of deep vein thrombosis.Methods From February 2015 to November 2016,62 cases of surgery patients in our hospital were admitted to department of orthopedics for elderly lower limb,and they randomly divided into the control group and the observation group according to number'expression method,with 31 eases in each group.One day before operation and 1 to 7 days after operation,the control group used low molecular weight heparin calcium,and the observation group was given promoting blood circulation for removing blood stasis prescription.The D-dimer level in different time,h deep venous thrombosis and bleeding complications was compared.Results:One week and 2 weeks after operation,two D-dimer levels of the observation group were lower than those of the control group.The D-dimer level after operation was higher than that one day before treatment and immediately after operation.The D-dimer level in one week and two weeks after operation was lower than 48 hours after surgery,and the difference was statistically significant (P <0.05).The thrombosis incidence of the observation group and the control group was 0 (0/31)and 9.7%(3/31),respectively,and there was no statistically significant difference (adjusted =2.41,P =0.121 >0.05 ).The total incidence of bleeding events of the observation group and the control group was 16.1% and 12.9%,respectively,and the difference was not statistically significant (adjusted =0.00,P =1.000 >0.05 ).Conclusion The promoting blood circulation for removing blood stasis prescription combined with low moleoular weight heparin calcium can reduce the level of D-direct in elderly patients with lower limb surgery.