低分子肝素钙和疏血通注射液在外科术后抗凝中的对比研究

Comparison of Shuxuetong Injection and low molecular weight heparin on postoperative anticoagulation

目的 对比疏血通注射液与低分子肝素钙（LMWH）用于外科术后的抗凝效果.方法 选取普通外科手术病例80例,年龄45-75岁,根据入院时间先后顺序随机分为两组,疏血通组（41例）术后静滴疏血通注射液抗凝,LMWH组（39例）术后皮下注射低分子肝素钙抗凝.通过观察并记录患者治疗前后凝血酶-抗凝血酶Ⅲ复合物（TAT）值、血红蛋白（Hb）、纤维蛋白原（FIB）、血浆凝血酶原时间（PT）、血小板计数（PLT）及随访3个月期间不良反应情况,评价疏血通注射液与低分子肝素钙的外科术后的抗凝效果.结果 与术前相比,术后1d时两组TAT值明显增加（P＜0.05）,使用抗凝药物后,术后5、7d时两组TAT值相比术后1d时明显下降（P＜0.05）,且术后5、7d时LMWH组TAT值明显低于疏血通组（P＜0.05）：术后1d与术后5d相比,两组在血红蛋白水平、血小板计数上均没有显著差异.与术后1d相比,术后5d两组FIB值均明显降低（P＜0.05）,PT值均明显延长（P＜0.05）.随访3个月期间,两组不良反应率相比,差异没有统计学意义.结论 低分子肝素钙和疏血通注射液均具有较好的抗凝作用,低分子肝素钙抗凝作用稍强,两药不良反应发生率无统计学意义,用于外科术后抗凝,均安全有效.

Objective To compare the efficacy of Shuxuetong Injection and low molecular weight heparin （LMWH） for anticoagnlation after surgery. Methods Totally 80 patients who had received sugery were selected and divided into two groups according to the sequence of admisson time. The Shuxuetong group （41 cases） was iv given Shuxuetong Injection for anticoagulation. The LMWH group （39 cases） was given low molecular weigth heparin calcium by hypodermic injection. The efficacy of anticoagulation of Shuxuetong Injection and low molecular weight heparin calcium after surgery was evaluated by TAT, Hb, FIB, PT, PLT and adverse reaction during 3 months follow-up. Results Compared with the value before surgery, the TAT values were increased after 1 d surgery （P 〈 0.05）. After the use of anticoagulant drugs, the TAT values in 5 d and 7 d after surgery were decreased significantly （P 〈 0.05）. And the TAT values in the LMWH group were lower than those of the Shuxuetong group. There was no statistical significance on Hb and PLT between two groups. Compare with the value after 1 d surgery, the FIB level was decreased and PT was extended （P 〈 0.05）. There were no statistical significance on adverse reaction between two groups during 3 months follow-up. Conclusion Low molecular weight heparin calcium and Shuxuetong Injection both have good anticoagulant effect. Low molecular weight heparin calcium has a reasonable price and stronger anticoagulation. There is no statistical significance on adverse reaction between two groups. Both of them could be used for anticoagulation after surgical operation.