益气通脉方与低分子肝素预防髋部大手术下肢深静脉血栓的随机对照研究

Randomized Control Study on Yiqitongmai Decoction and Low Molecular Weight Heparin for Preventing Deep Vein Thrombosis in the Patients Received Major Hip Surgery

目的:观察益气通脉方与低分子肝素预防髋部大手术下肢深静脉血栓的临床疗效并评价其安全性。方法:收集2011年10月至2015年6月髋部大手术患者共46例,随机分为试验组和对照组,各23例。试验组给予口服益气通脉汤,对照组给予皮下注射低分子肝素钙,治疗、观察周期2周,对比两组术后2周下肢深静脉血栓发生率及不良反应发生率。结果:试验组小腿肌间静脉血栓2例,股前静脉血栓1例,股深静脉血栓1例,DVT发生率19.04%;对照组小腿肌间静脉血栓2例,股深静脉血栓1例,DVT发生率14.28%;两组在DVT发生率和术后并发症方面,差异无统计学意义(P>0.05)。试验组术后出血量小于对照组(P<0.05)。结论:益气通脉方具有预防老年患者髋部大手术深静脉血栓形成的作用,与低分子肝素相比,益气通脉方减少了术后出血,为益气活血利水法有效预防DVT提供了临床依据,两者安全性相当。

Objective：To observe the therapeutic effect and assess the safety of Yiqitongmai decoction and low molecular weight heparin for preventing deep vein thrombosis（DVT）in senile patients received major hip surgery. Methods.. Forty six patients received major hip surgery were enrolled from October 2011 to June 2015. They were randomly divided into ex- perimental group and control group（23 cases in each group）. The experimental group was given oral Yiqitongmai decoc- tion. The control group was given low molecular weight heparin（LMWH）hypodermic injection. The therapeutic and obser- vation period was 2 weeks. The clinical symptoms, physical signs, bleeding tendency,and the changes of color Doppler Ul- trasound were documented. Results.. There were two cases with calf muscular venous thrombosis, one case with anterior femoral venous thrombosis, and one case with deep femoral venous thrombosis in the experimental group. And there were 2 cases with calf muscular venous thrombosis and one case with deep femoral venous thrombosis in the control group. The incidence of DVT was 19.04 % and 14.28 % respectively. The DVT rate and the complication was not significantly differ- ent between two groups（P〈0.05）. The postoperative blood volume in the experimental group was less than the control group（P〈0.05）. Conclusion：The Yiqitongmai decoction is effective for preventing DVT in senile patients received major hip surgery. Compared with LMWH, Yiqitongmai decoction can decrease the bleeding, with the same safety.