地奥司明在老年髋部骨折患者术后下肢深静脉血栓形成中的防治效果研究

Study on the prevention and treatment effect of diosmin on deep vein thrombosis of lower limbs in elderly patients with hip fracture

目的研究地奥司明在预防老年髋部骨折患者术后下肢深静脉血栓形成(DVT)中的应用效果。方法选取该院2016年1月至2018年10月老年髋部手术患者141例作为研究对象。根据随机数字表法将其分为对照组68例、观察组73例。对照组给予低分子肝素钙治疗,观察组在此基础上给予地奥司明治疗。用药10d后,比较2组患者的DVT发生率、D-二聚体水平、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、血小板计数、术中出血量、术后引流量、患侧小腿周径及不良反应发生率。结果术后10d,观察组DVT发生率明显低于对照组,差异有统计学意义(P<0.05)。观察组术后10d患侧小腿周径、术前与术后10d患侧小腿周径的差值均明显低于对照组,差异均有统计学意义(P<0.05)。观察组术后10d血清D-二聚体水平低于对照组,APTT、PT均高于对照组,差异均有统计学意义(P<0.05)。2组患者手术前后血小板计数比较差异无统计学意义(P>0.05)。观察组术中出血量及术后引流量均低于对照组,差异均有统计学意义(P<0.05)。结论在低分子肝素钙治疗的基础上加用地奥司明,可明显提高老年髋部骨折患者术后下肢DVT的防治效果,显著减轻术后患侧小腿肿胀,降低血液黏稠度,且不会增加术后出血的发生风险及不良反应,值得临床重视。

Objective To investigate the effect of diosmin in preventing lower extremity deep vein thrombosis(DVT)in elderly patients with hip fracture.Methods A total of 141 elderly patients with hip surgery in the hospital from January 2016 to October 2018 were selected as the research objects.According to the random number table method,it was divided into 68 cases in the control group and 73 cases in the observation group.The control group was given low-molecular-weight heparin calcium,and the observation group was given diosmin.After 10 days of treatment,multiple indicators were compared in the two groups:DVT incidence,D-dimer level,activated partial thromboplastin time(APTT),prothrombin time(PT),platelet count,intraoperative blood loss,postoperative drainage,and in the calf circumference incidence of adverse reactions.Results At 10 days after surgery,the incidence of DVT in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The difference between the calf circumference of the affected side at 10 days after surgery and the calf circumference of the affected side before and 10 days after surgery were significantly lower in the observation group than in the control group(P<0.05).The serum D-dimer level in the observation group was lower than that in the control group at 10 days after operation,and the APTT and PT were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in platelet count between the two groups before and after surgery(P>0.05).The intraoperative blood loss and postoperative drainage volume of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The addition of Diosmin on the basis of low-molecular-weight heparin calcium treatment can significantly improve the prevention and treatment of lower extremity DVT in elderly hip fracture patients,significantly reduce the swelling of the affected leg,reduce blood viscosity,and will not increase the surgery.The risk of postbleeding and adverse reactions deserve clinical attention.