三七总皂苷联合低分子肝素预防人工关节置换术后深静脉血栓形成的疗效观察

Therapeutic effect of Panax notoginseng saponins combined with low molecular weight heparin on prevention of deep vein thrombosis after artificial joint replacement

目的:探讨三七总皂苷联合低分子肝素对预防人工关节置换术后深静脉血栓形成(deep venous thrombosis,DVT)的效果,同时应用血栓弹力图(TEG)检测患者整体的血液状态.方法:将65例骨科行人工关节置换的住院患者,采用简单随机分组的方法分为2组,观察组(共35例)给予三七总皂苷联合低分子肝素,对照组(共30例)给予低分子肝素,比较2组DVT发生率、凝血指标及TEG相关指标的变化.结果:术后应用三七总皂苷联合低分子肝素的病人有7例术后经超声证实为DVT,而应用低分子肝素的病人有10例术后经彩超证实为DVT,所有用三七总皂苷的病人均未见出血.结论:三七总皂苷联合低分子肝素能明显改善人工关节置换术后病人的血液状态,具有降低血液高凝状态,抑制血小板聚集,降低纤维蛋白原,提高纤溶活性的作用,是一种安全、有效的方法.

Objective:To investigate the effect of Panax notoginseng saponins combined with low molecular weight heparin on prevention of deep venous thrombosis(DVT)after artificial joint replacement.At the same time,thrombus elasticity map(TEG)was used to detect the overall blood status of patients.Methods:Sixty一five inpatients with orthopedic arthroplasty were divided into two groups by simple randomization.The experimental group(35 cases)was given Panax notoginseng saponins combined with low molecular weight heparin,and the control group(30 cases)was given low molecular weight heparin,and the incidence of DVT,coagulation parameters and changes in TEG related indicators were compared between the two groups.Results:Seven patients with Panax notoginseng saponins and low molecular weight heparin were confirmed to have DVT after ultrasound.However,ten patients with low molecular weight heparin were confirmed to have DVT after ultrasound.No bleeding occurred in All patients with Panax notoginseng saponins.Conclusion:Panax notoginseng saponins combined with low molecular weight heparin could significantly improve the blood status of patients after artificial joint replacement.It had the functions of lowering blood hypercoagulability,inhibiting platelet aggregation,reducing fibrinogen and increasing fibrinolytic activity.It was a safe,effective method.