血必净注射液对老年骨折并机械通气患者凝血功能及深静脉血栓形成的影响

The effect of Xuebijing injection on coagulation function and prevention of deep venom thrombosis in elderly fracture patients with mechanical ventilation

目的探讨血必净注射液对老年骨折并机械通气患者凝血功能的影响及预防深静脉血栓（DVT）的临床效果。方法60例患者按照数字表法随机分成对照组（30例）和治疗组（30例），对照组行物理治疗预防深静脉血栓，治疗组在对照组的基础上加用血必净注射液治疗。观察两组患者各时间点的凝血功能指标和乳酸值（Lac）的变化。统计两组患者的内脏出血发生率、DVT发生率、APACHEII评分及28d病死率。结果治疗组第3、5天的凝血酶原时间（PT）、活化部分酶原时间（APTT）、D-二聚体（DD）和第5天的纤维蛋白原（Fg）与治疗前比较差异均有统计学意义（均P〈0．05）；在治疗第3、5天的PT、AFFF和第5天的DD与对照组比较差异均有统计学意义（均P〈0．05）。两组各个时间点的血小板计数（PLT）、Lac、出血发生率和病死率差异无统计学意义（P〉0．05）。治疗组深静脉血栓的发生率比对照组明显降低（20．00％比3．33％）（x2=4．043，P=0．044）。两组APACHEII评分均较前下降，治疗组APACHEII评分下降更为明显（t=5．48，P=0．000）。结论血必净注射液能够改善老年骨折并机械通气患者的凝血状态，降低深静脉血栓的发生率。

Objective To study effect of Xuebijing injection on coagulation function and prevention of deep venous thrombosis in elderly fracture patients with mechanical ventilation. Methods 60 patients were randomly divided into control group（ 30 cases） and Xuebijing group（30 cases）. Xuebijing group received Xuebijing injection, besides physical therapy for prevention of deep venous thrombosis received by control group. Coagulation parameters and Lac at different time points, thrombosis incidence, hemorrhage incidence APACHE II score and 28 - day mortality were compared between the two groups. Results In Xuebijing group, PT, APTI＇, DD on d3 and Fg 48 on d5 had statistically significant differences compared with before treatment. PT, A1GT on d3, d5 and DD on d5 were statistical- ly different compared with the control group（ P 〈 0.05 ）. PLT, Lac, hemorrhage incidence and 28 -day mortality had no significant differences between the two groups. Thrombosis incidence in Xuebijing group was significantly lower than the control group （20.00% vs 3.33% ） （ x2 = 4. 043, P = 0. 044, P 〈 0.05 ）. Both of APACHE II score were lower than before treatment, but the Xuebijing group was significantly decreased （ t = 5.48, P = 0. 000, P 〈 0.05 ）. Conclusion Xuebijing injection could improve coagulation function, and decrease thrombosis incidence in elderly fracture patients with mechanical ventilation.