苦碟子预防老年骨盆髋臼骨折术后下肢深静脉血栓形成的临床研究

Clinical Observation of Kudiezi Combined with Low Molecular Weight Heparin on Preventing Deep Venous Thrombosis of Lower Extremities after Pelvic and Acetabular Fractures in Elderly Patients

目的:探讨苦碟子注射液联合低分子肝素预防老年骨盆及髋臼骨折术后下肢深静脉血栓(LEDVT)形成的效果及机制。方法:选取2018年1月—2019年1月老年骨盆髋臼骨折患者共100例,采用随机数字法分为对照组(n=50)及观察组(n=50)。在常规治疗基础上,对照组术后给予低分子肝素治疗,观察组术后给予低分子肝素联合苦碟子注射液治疗。治疗后,比较两组患者LEDVT发生率、患肢肿胀程度、疼痛程度、血液流变学指标、炎性因子水平、凝血功能及不良反应发生情况。结果:术后30天内,LEDVT发生率观察组为6%,低于对照组的20%,差异有统计学意义(P<0.05)。术后7天,与对照组比,观察组血液流变学指标及炎性因子显著下降,差异有统计学意义(P<0.05)。患肢肿胀、疼痛程度观察组较对照组明显减轻,差异有统计学意义(P<0.05)。观察组与对照组凝血功能差异无统计学意义(P>0.05)。观察组与对照组不良反应发生率分别为6%和4%,差异无统计学意义(P>0.05)。结论:苦碟子注射液联合低分子肝素能够有效预防老年骨盆髋臼骨折术后LEDVT的发生,显著改善患者血液流变学指标,减轻机体炎症反应,减轻患者患肢肿胀、疼痛程度,且不良反应轻微,临床上值得推广应用。

Objective To investigate the clinical effect and mechanism of Kudiezi injection combined with low molecular weight heparin on preventing deep venous thrombosis of lower extremities after pelvic and acetabular fractures in elderly patients.Methods From January 2018 to January 2019,100 elderly patients of pelvic and acetabular fractures in our hospital were divided into the observation group(n=50)and the control group(n=50)randomly.Besides conventional treatments,the control group was given low molecular weight heparin,while the observation group was given Kudiezi injection and low molecular weight heparin.Then,the incidence of DVT,the degree of limb swelling and pain,hemodynamic indexes,level of inflammatory factors and adverse reactions were observed and compared.Results 30 days after operation,the incidence of DVT in the observation group was 6%,which was statistically lower than that of 20%in the control group(P<0.05).One week after operation,hemodynamic indexes and inflammatory factors in the observation group were respectively statistically lower than those in the control group(P<0.05).The degree of limb swelling and pain was statistically lower than that of the control group(P<0.05).The incidence of adverse reactions in the observation group was 6%,which was statistically the same with that of 4%in the control group(P>0.05).Conclusion Treatment of Kudiezi injection combined with low molecular weight heparin can effectively prevent the incidence of lower extremities DVT on elderly patients after pelvic and acetabular fractures.It can significantly improve hemodynamic indexes and alleviate inflammatory reaction with minor adverse reactions.