丹参多酚酸盐联合低分子肝素预防术后深静脉血栓Meta分析

Efficacy and Safety of Salvianolate Combined with Low Molecular Heparin for Prevention of Postoperative Deep Venous Thrombosis: A Meta-analysis

目的:评价丹参多酚酸盐联合低分子肝素预防术后深静脉血栓的疗效及安全性。方法:全面检索Pub Med、Cochrane Library、EMbase、CNKI、万方和维普数据库中收录的丹参多酚酸盐联合低分子肝素预防术后深静脉血栓(DVT)的随机对照研究(RCT),检索时限均从2000年1月—2017年6月。提取资料进行质量评价,采用Rev Man5.3软件进行Meta分析。结果:共纳入5个RCT,包括623例患者,2篇为骨科手术,3篇为妇科手术;与对照组相比,联合组显著降低DVT发生率(P<0.00001),亚组分析显示,联合组降低了骨科手术(P=0.02)及妇科手术DVT发生率(P=0.0003);此外联合组显著降低了D-二聚体水平(P<0.00001),两组不良反应发生率无明显差异。结论:丹参多酚酸盐联合低分子肝素预防术后静脉血栓疗效优于单用低分子肝素,但仍需设计良好的大样本RCT对照研究进一步验证。

Objective To evaluate the efficacy and safety of salvianolate combined with low molecular heparin for prevention of postoperative deep venous thrombosis （DVT）. Methods Randomized controlled trials （RCTs） of low molecular heparin combined with salvianolate for prevention of postoperative DVT were searched from PubMed, Cochrane Library, EMbase, CNKI, VIP and Wanfang database from January 2000 to June 2017. According to inclusion and exclusion criteria, the literatures were screened. Then the data were extracted and processed by Revman5.3. Results Five RCTs involving 623 patients were enrolled, including two studies for orthopaedics operations and other three for gynaecologic operations. The results showed that the combined group could lower the DVT rate signi？cantly （P 〈0.01）, and the same results were observed in the subgroup of orthopedic operation （P = 0.02） and gynecologic operation （P = 0.0003）. Furthermore, the combined group had lower D-dimer levels （P〈0.01）. There was no significant difference in adverse events between the combined group and control group. Conclusion Based on the current clinical evidence, the low molecular heparin combined with salvianolate has a better effect on postoperative DVT than low molecular heparin used alone. The ？ndings require more high-quality and large multicenter RCTs to verify.