丹参川芎嗪注射液结合低分子肝素钙对脊柱骨折后下肢深静脉血栓的预防效果观察

Observation on Preventive Efficacy of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection Combined with Low Molecular Weight Heparin Calcium on Blood Flow of Deep Venous Thrombosis of Lower Extremity After Spinal Fracture

目的:探讨丹参川芎嗪注射液辅助低分子肝素钙应用于脊柱骨折疾病,对患者下肢深静脉血栓的预防效果。方法:选取2016年1月至2017年9月西南医科大学附属中医医院骨伤科收治的脊柱骨折患者105例作为研究对象,随机分为观察组(n=54)和对照组(n=51)。观察组用丹参川芎嗪注射液+低分子肝素钙治疗,对照组采取低分子肝素钙单独给药治疗。治疗前和治疗10d后观察2组血流动力学、血液流变学、凝血功能指标变化,及统计下肢深静脉血栓发生情况。结果:1)治疗后观察组血流动力学参数Ratio(0.85±0.25)、SVC(8.92±1.32)mmHg、MVO(7.62±1.17)mmHg、VRT(14.83±3.56)s显著高于对照组(P<0.05);2)治疗后观察组血流变指标红细胞沉降率(10.47±2.84)mm/h、高切(3.92±0.59)mPa·s、低切(8.83±0.73)mPa·s、红细胞压积(46.71±5.20)%、全血黏度(3.62±0.57)mPa·s、红细胞聚集指数(2.81±0.66)显著低于对照组(P<0.05);3)治疗后观察组凝血功能APPT(32.71±4.25)s、PT(17.47±2.84)s显著高于对照组,FIB(2.62±0.37)g/L、D-D(2.91±0.32)mg/L显著低于对照组(P<0.05);4)观察组下肢深静脉血栓阳性率(5.56%)显著低于对照组(15.69%)(P<0.05)。结论:对于脊柱骨折下肢深静脉血栓的预防,可在西药低分子肝素钙治疗基础上,增加丹参川芎嗪注射液辅助治疗,能够有效促进患者血液流变学、血流动力学指标的恢复,对凝血功能、防止下肢深静脉血栓有明显作用。

Objective: To explore preventive efficacy of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with low molecular weight heparin calcium on blood flow of deep venous thrombosis of lower extremity after spinal fracture. Methods: From January 2016 to September 2017,105 patients with spinal fracture admited in the orthopedics department of the hospital were selected.They were randomly divided into 2 groups according to different strategies of preventing deep venous thrombosis of lower extremity.The treatment group( n =54)was treated with the Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with the low molecular weight heparin calcium.The control group( n =51)was treated with the low molecular weight heparin calcium alone.Index changes of hemodynamics,hemorheology,coagulation function and the occurrence of deep venous thrombosis of lower extremity were observed before the treatment and 10 days after the treatment. Results: 1)After the treatment,the hemodynamic parameters in the treatment group-Ratio(0.85±0.25),SVC(8.92±1.32)mmHg,MVO(7.62±1.17)mmHg,VRT(14.83±3.56)s were significantly higher than those in the control group( P <0.05). 2)After the treatment,in the treatment group,the hemorheological indexes-erythrocyte sedimentation rate(10.47±2.84)mm/h,high shear rate(3.92±0.59)mPa·s,low shear rate(8.83±0.73)mPa·s,hematocrit(46.71±5.20)%,whole blood viscosity(3.62±0.57)mPa·s,erythrocyte aggregation index(2.81±0.66)were significantly lower than those in the control group( P <0.05). 3)After the treatment,the coagulation function in the treatment group-APPT(32.71±4.25)s,PT(17.47±2.84)s were significantly higher than those in the control group;FIB(2.62±0.37)g/L,D-D(2.91±0.32)mg/L were significantly lower than those in the control group( P <0.05). 4)In the treatment group,the positive rate(5.56%)of deep venous thrombosis was significantly lower than that in the control group(15.69%)( P <0.05). Conclusion: For the prevention of deep venous thrombosis in lower extremity after spinal fracture,the adjuvant therapy of Salviae Miltiorrhiza and Ligustrazine Hydrochloride Injection can be used on the basis of low molecular weight heparin calcium.It can effectively promote the recovery of hemorheology and hemodynamics in the patients.It has obvious efficacy on improving coagulation function and preventing deep venous thrombosis of lower extremity.