丹参片对髋部骨折术后DVT风险及凝血-纤溶指标的影响

Effects of Danshen tablets on the risk of the deep vein thrombosis and parameters of coagulation and fibrinolysis after hip fracture surgery

目的研究丹参片对髋部骨折术后深静脉血栓(DVT)风险及凝血-纤溶指标的影响。方法选择2021年12月至2022年12月收治的行髋部骨折术患者86例,随机数字表法分为观察组和对照组,每组43例。对照组给予低分子肝素钙注射液,观察组在对照组基础上给予丹参片,疗程均为2周。记录术后1个月内2组DVT发生情况,比较2组治疗前后凝血功能指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]水平,比较2组治疗前后纤溶指标[D-二聚体(D-D)、纤溶酶原激活物抑制物1(PAI-1)、组织纤溶酶原激活物(t-PA)]水平,比较2组治疗前后Harris评分、Barthel指数、视觉模拟评分(VAS),记录2组用药期间不良反应。结果观察组DVT发生率显著低于对照组(P<0.05)。2组PT、TT、APTT水平较治疗前均显著升高(P<0.05),FIB水平较治疗前显著下降(P<0.05),且观察组PT、TT、APTT水平高于对照组(P<0.05),观察组FIB水平低于对照组(P<0.05)。2组D-D、PAI-1水平较治疗前显著降低(P<0.05),t-PA水平较治疗前显著上升(P<0.05),且观察组D-D、PAI-1水平低于对照组(P<0.05),观察组t-PA水平高于对照组(P<0.05)。2组Harris评分、Barthel指数评分较治疗前上升,VAS评分较治疗前下降(P<0.05),2组Harris评分、Barthel指数、VAS评分组间比较无明显差异(P>0.05)。2组不良反应总发生率差异无统计学意义(P>0.05)。结论丹参片能够显著降低髋部骨折术后DVT风险,并改善患者凝血功能及纤溶指标,同时具有较高安全性,可用于临床预防术后DVT。

Objective To investigate the effect of Danshen tablets on the risk of deep vein thrombosis(DVT)and the parameters of coagulation and fibrinolysis after hip fracture surgery.Methods A total of 86 patients who underwent hip fracture surgery from December 2021 to December 2022 were included in the study.They were randomly divided into observation group(n=43)and control group(n=43).Patients in both groups were given low-molecular-weight heparin calcium injection,and those in the observation group were additionally given Danshen tablets.The course of treatment lasted 2 weeks.The occurrence of DVT in the two groups within 1 month after operation was recorded.Coagulation function indexes,including prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB),and fibrinolytic indexes,including D-dimer(D-D),plasminogen activator inhibitor 1(PAI-1),and tissue plasminogen activator(t-PA)before and after treatment between the two groups were compared.In addition,the Harris Hip Score(HHS),Barthel index(BI)and Visual Analogue Scale(VAS)scores before and after treatment between groups were compared.The adverse events during the course of treatment were recorded.Results The incidence of DVT in the observation group was significantly lower than that in the control group(P<0.05).After treatment,significantly increased PT,TT and APTT,and significantly decreased FIB were detected in both groups than those before treatment(P<0.05).Besides,PT,TT and APTT after treatment were significantly higher in the observation group,and FIB was significantly lower than those in the control group(P<0.05).After treatment,D-D and PAI-1 levels significantly decreased,and t-PA level significantly increased in both groups(P<0.05).Compared with the control group after treatment,D-D and PAI-1 levels were significantly lower,and t-PA level was significantly higher in the observation group(P<0.05).After treatment,the scores of HHS and BI in both groups significantly increased,and the VAS score significantly decreased than those before treatment(P<0.05).There were no significant differences in the HHS,BI and VAS scores between the two groups(P>0.05).No significant difference in the total incidence of adverse events was detected between the two groups(P>0.05).Conclusion Danshen tablets can significantly reduce the risk of DVT after hip fracture surgery,and improve the coagulation function and fibrinolysis indexes with a high safety,which can be used in clinical prevention of DVT after hip fracture surgery.