低分子肝素联合血栓通预防断指再植术后血栓形成疗效观察

Curative Effect Observation of Xueshuantong Combined with Low Molecular Weight Heparin in the Prevention of Thrombosis after Replantation of Amputated Finger

目的:探讨注射用血栓通联合低分子肝素预防断指再植术后血栓形成的临床疗效。方法:62例断指再植术后患者随机分为观察组和对照组各31例。观察组给予低分子肝素钠4 500 IU,ih qd联合注射用血栓通150 mg+5%葡萄糖注射液200 ml,ivd bid治疗,对照组单纯予低分子肝素钠4 500 IU,ih qd治疗,疗程均为3 d。比较两组患者治疗前后D-二聚体、纤维蛋白原、血红蛋白、血小板、凝血酶原时间、凝血时间差异,观察治疗后两组患者发生血管痉挛、血管栓塞、指体坏死的情况差异及两组疗效、药品不良反应。结果:治疗后,两组纤维蛋白原、血小板、凝血酶原时间、凝血时间等指标均有显著改善(P<0.05),且观察组上述指标改善情况明显优于对照组(P<0.05)。观察组发生血管痉挛1例,明显少于对照组的6例(P<0.05),两组血管栓塞、指体坏死发生率差异无统计学意义(P>0.05)。两组疗效分布比较,观察组明显优于对照组(P<0.05),且观察组的愈合优良率也显著高于对照组(P<0.05)。两组药品不良反应发生率差异也有统计学意义(P<0.05。结论:注射用血栓通联合低分子肝素预防断指再植术后血栓形成,能显著改善患者凝血功能,减少血管痉挛发生,安全性高,疗效优于单纯使用低分子肝素。

Objective： To discuss the clinical effect of Xueshuantong injection combined with low molecular weight heparin in the prevention of thrombosis in patients after replantation of amputated finger. Methods： 62 cases of replantation of amputated fingers were divided randomly into observation group and control group with 31 cases in each group,the observation group was treated with low molecular weight heparin 4 500 IU,ih qd combined with Xueshuantong injection 150 mg ＋5% glucose injection 200 ml,ivd bid. Control group were treated with low molecular weight heparin sodium 4 500 IU,ih qd,all treated for 3 days. The differences in two groups of patients of the D-dimer,fibrinogen,hemoglobin,platelet,prothrombin time,coagulation time before and after the treatment were compared,and the differences in two groups of vasospasm,embolization,necrosis,effectivenes and adverse drug reactions were observed. Results： After treatment,fibrinogen,platelets,prothrombin time,clotting time of the two groups were both significantly improved（ P 0. 05）,and observation group was significantly higher than those in control group（ P 0. 05）. There is 1 case of vasospasm in obeservation group,which is much less than 6 cases in the control group（ P 0. 05）. The incidences of embolization and necrosis in the two groups had no significant difference（ P 0. 05）. On the effect distribution,,the observation group was better than the control group（ P 0. 05）,and excellent healing rate in the observation group was also significantly higher（ P 0. 05）. The difference of adverse drug reactions rate in two groups was statistically significant（ P 0. 05）. Conclusion： Xueshuantong injection combined with low molecular weight heparin in the prevention of thrombosis in patients after replantation of amputated finger,it can significantly improve blood coagulation function and reduce vasospasm,more safety and effective than the simple use of low molecular weight heparin.