苦碟子联合低分子肝素预防人工关节置换术后下肢深静脉血栓形成的效果观察

Clinical observation of the effect of Kudiezi combined with low molecular heparin in preventing the formation of lower extremity deep-vein thrombosis after artificial joint replacement

目的观察苦碟子联合低分子肝素预防人工关节置换术后下肢深静脉血栓(DVT)形成的效果。方法选取接受人工关节置换术的患者80例,用随机数字法分为观察组和对照组,每组40例。对照组给予低分子肝素预防人工关节置换术后下肢DVT,观察组在对照组的基础上联合苦碟子进行下肢DVT的预防。比较两组患者的凝血功能(血浆凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)、出血情况、术后血栓发生率以及炎性因子TNF-α、IL-6、IL-8水平。结果给药2周后,两组患者的凝血功能指标均低于治疗前(P<0.01),观察组PT和APTT的变化幅度小于对照组,FDB、D-D、PLT等指标的变化幅度大于对照组(P<0.01);两组患者的TNF-α、IL-6、IL-8水平均低于治疗前(P<0.01),且观察组变化幅度更大(P<0.01)。观察组血栓和出血的发生率均低于对照组(P<0.05或0.01)。结论苦碟子联合低分子肝素在预防人工关节置换术后下肢DVT形成方面的效果较好,值得临床推广应用。

Objective To observe the clinical efficacy of Kudiezi combined with low molecular heparin in preventing the formation of lower extremity deep-vein thrombosis (DVT) after artificial joint replacement. Methods Eighty patients who underwent artificial joint replacement were divided into the Observation Group and Control Group by random number method, 40 cases in each group. The Control Group was given low molecular heparin to prevent the formation of lower extremity DVT after artificial joint replacement. The Observation Group was given low molecular heparin combined with Kudiezi to prevent lower extremity DVT. The two groups were compared in terms of coagulation function (PT, APTT, FIB), D-D, PLT, bleeding, postoperative thrombosis rate and inflammatory factors (TNF-α, IL-6, IL-8) levels. Results Two weeks after the administration, the coagulation function indexes of the two groups were lower than those before the treatment (P<0.01), the changes in the PT and APTT in the Observation Group were less than those in the Control Group, the changes in FDB, D-D and PLT in the Observation Group were all greater than those in the Control Group (P<0.01), and both groups had the levels of TNF-α, IL-6 and IL-8 lower than those before the treatment (P<0.01), and the Observation Group had a more significant change. The incidences of thrombus and bleeding in the Observation Group was lower than those of the Control Group (P<0.05 or 0.01). Conclusion Kudiezi combined with low molecular heparin has a good curative effect in the prevention of the formation of lower extremity DVT after artificial joint replacement, which is worth clinical promotion.