疏血通注射液预防骨科大手术后深静脉血栓的临床效果

Clinical Effect of Shuxuetong Injection on Prevention of Deep Venous Thrombosis after Major Orthopaedic Surgery

目的探讨疏血通注射液预防骨科大手术后深静脉血栓的临床效果。方法选取2011年12月-2017年12月在我院行骨科大手术的患者61例,按照入院先后顺序分为两组,对照组给予常规阿司匹林和低分子肝素钙进行预防,观察组在对照组的基础上联合疏血通注射液进行预防。对比两组患者治疗前后的肢体肿胀程度、疼痛程度、ET、TXB2、6-Keto-PGF1α水平、凝血功能和DVT发生率。结果治疗前两组患者的肢体肿胀程度评分和疼痛程度评分无统计学差异(P>0.05),治疗后两组患者的肢体肿胀程度评分和疼痛程度评分均显著下降,且观察组显著低于对照组(P<0.05);两组患者治疗前ET、TXB2和6-Keto-PGF1α水平均无统计学差异(P>0.05),治疗后两组ET和TXB2水平显著升高,6-Keto-PGF1α水平显著下降(P<0.05),且观察组ET和TXB2水平低于对照组,6-Keto-PGF1α水平高于对照组(P<0.05);两组患者治疗前后TT、PT和APTT相比均无统计学差异(P>0.05);观察组DVT的发生率显著低于对照组(P<0.05)。结论在常规西药治疗的基础上联合疏血通注射液可显著降低骨科大手术后患者的肢体肿胀程度、疼痛程度和DVT发生率,且不影响患者的凝血功能,可能与其可有效降低术后ET、TXB2水平和升高6-Keto-PGF1α水平有关。

Objective To explore the clinical effect of Shuxuetong injection in preventing deep vein thrombosis after major orthopaedic surgery.Methods Sixty-one patients who underwent major orthopedic surgery in our hospital between December 2011 and December 2017 were selected and divided into two groups according to the time of hospitalization. The control group was given conventional aspirin and low molecular heparin calcium to prevent deep vein thrombosis while the observation group was additionally given Shuxietong injection for prevention. The degree of limb swelling,pain,ET,TXB2,6-keto-PGF1,coagulation function and DVT incidence were compared between the two groups before and after treatment. Results The degree of limb swelling and pain score before treatment were not significantly different between the two groups（ P〈0.05）,but after treatment,the degree of limb swelling and pain score were significantly decreased in both groups,especially in the observation group（ P〈0.05）.Before treatment,the difference in ET,TXB2 and 6-Keto-PGF1 alpha levels between the two groups was not of statistical significance（ P〈0.05）. After treatment,the levels of ET and TXB2 were significantly increased,6-Keto-PGF1 was significantly decreased,and the levels of ET and TXB2 in the observation group were lower than those of the control group,but the levels of 6-Keto-PGF1 alpha were higher（ P〈0.05）. There was no statistically significant difference in TT,PT or APTT between the two groups before and after treatment（ P〈0.05）.The incidence of DVT in the observation group was significantly lower than that in the control group（ P〈0. 05）. Conclusion On the basis of conventional treatment with western medicine,the combination with Shuxuetong injection can significantly reduce limb swelling,pain and incidence of DVT among patients undergoing major orthopedic surgery,without affecting patients＇ blood coagulation function. The mechanism may be related to decreased ET and TXB2 levels and increased 6-keto-PGF1 levels.