苦碟子注射液联合低分子肝素预防髋关节置换术后下肢深静脉血栓形成的疗效观察

Clinical Observation of Kudiezi Injection Combined with Low Molecular Weight Heparin in the Prevention of Lower Extremity Deep Venous Thrombosis After Hip Replacement

目的:探讨苦碟子注射液联合低分子肝素预防髋关节置换术后下肢深静脉血栓(deep venous thrombosis,DVT)形成的临床疗效。方法:选取哈励逊国际和平医院于2017年1月至2019年1月收治的拟行髋关节置换术的患者120例,以随机数字表法分为对照组(n=60)和观察组(n=60)。对照组患者术后给予低分子肝素治疗,观察组患者术后给予低分子肝素联合苦碟子注射液治疗。比较两组患者下肢DVT发生率、患肢肿胀程度及疼痛程度,血液流变学指标、D-二聚体、炎症因子和凝血功能指标水平及不良反应发生情况。结果:术后30 d内,观察组患者DVT发生率为5.00%(3/60),明显低于对照组的16.67%(10/60),差异有统计学意义(χ2=4.23,P <0.05)。术后7 d,观察组患者患肢肿胀程度及疼痛程度较对照组明显减轻;观察组患者血液流变学指标、炎症因子及D-二聚体水平较对照组明显降低,差异均有统计学意义(P <0.05)。观察组、对照组患者的不良反应发生率分别为8.33%(5/60)、6.67%(4/60),差异无统计学意义(P> 0.05)。术前及术后7 d,两组患者凝血功能指标水平比较,差异均无统计学意义(P> 0.05)。结论:苦碟子注射液联合低分子肝素能够降低髋关节置换术后患者的血液流变学指标及炎症因子水平,减轻患者疼痛及患肢肿胀,减少DVT发生。

OBJECTIVE:To probe into the clinical efficacy of Kudiezi injection combined with low molecular weight heparin in the prevention of lower extremity deep venous thrombosis(DVT)after hip replacement.METHODS:Totally 120 patients with hip replacement admitted into Harrison International Peace Hospital from Jan.2017 to Jan.2019 were extracted to be divided into the the observation group(n=60)and the control group(n=60)via the random number table.Patients in the control group were treated with low molecular weight heparin after surgery,while the observation group received low molecular weight heparin combined with Kudiezi injection after surgery.The incidence of DVT,the degree of limb swelling and pain,hemorheology,D-dimer,level of inflammatory factors and adverse drug reactions of two groups were observed and compared.RESULTS:After surgery of 30 d,the incidence of DVT in the observation group was 5.00%(3/60),significantly lower than 16.67%(10/60)in the control group,the difference was statistically significant(χ2=4.23,P<0.05).After surgery of 7 d,the degree of swelling and pain of the observation group was significantly lower than that of the control group;and the difference was statistically significant(P<0.05).After surgery of 7 d,the levels of hemorheology,inflammatory factors and D-dimer in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse drug reactions in the observation group and the control group was 8.33%(5/60)and 6.67%(4/60),respectively,with no statistically significant difference(P>0.05).There was no statistically significant difference in the levels of coagulation function indexes between two groups before surgery and after surgery of 7 d(P>0.05).CONCLUSIONS:Kudiezi injection combined with low molecular weight heparin can reduce hemorheology and inflammatory factor levels in patients after hip replacement,relieve pain and swelling of affected extremity,and decrease the occurrence of DVT.