前列地尔结合丹参注射液防治老年髋部骨折下肢深静脉血栓效果观察

Observation on the Clinical Efficacy of Alprostadil Combined with Salvianolate Injection in Prevention of Deep Vein Thrombosis Around the Geriatric Hip Fracture

目的:探讨联合应用前列地尔与丹参注射液防治老年髋部骨折下肢深静脉血栓(deep vein thrombosis,DVT)的临床效果。方法:选取2013年1月-2018年1月老年髋部骨折患者62例,年龄68～85岁,平均(74.0±3.2)岁。其中股骨颈骨折行人工双极股骨头置换术24例,股骨转子间骨折行股骨近端髓内钉内固定术38例。随机分为两组,各31例,观察组术后每日联合静滴前列地尔注射液20μg+丹参注射液20 ml,对照组术后皮下注射低分子肝素钠4 000 IU/d,疗程均为2周。根据患肢术后疼痛、肿胀情况,皮下出血、伤口内血肿是否形成,术后第14天复查多普勒超声有无血栓形成等指标,比较两组的临床疗效。结果:治疗2周后,观察组优17例,良11例,可3例,差0例,优良率为90.3%,3例存在轻度DVT,无皮下出血发生;对照组优19例,良8例,可2例,差2例,优良率为87.1%,其中2例出现DVT,术后切口引流量明显增加2例,皮下出血1例。两组优良率及DVT发生率比较,差异均无统计学意义(P>0.05)。两组在治疗期间均无严重出血。结论:联合应用前列地尔加丹参与单用低分子肝素均具有较低的DVT发生率,值得临床推广。

Objective:To study the preventive effect of Alprostadil combined with Salvianolate Injection in prevention of deep vein thrombosis around the geriatric hip fracture surgery.Method:From January 2013 to January 2018,62 cases of hip fracture in elderly patients,aged from 68 to 85 years,average(74.0±3.2)years.There were 24 cases with artificial femoral head replacement for treating femoral neck fractures and 38 cases in intertrochanteric fractures group treated with PFNA.They were divided into two groups,31 cases in each group.The observation group treated with Alprostadil 20μg combined with Salvianolate Injection 20 ml by intravenous drip per day,the control group treated with Low Molecular Weight Heparin(LMWH)4 000 IU/d by subcutaneous injection for two weeks.The subcutaneous ecchymosis,incision hematoma bleeding and the degree of limb swelling after operation in two groups were observed.The clinical efficacy of the two groups was compared on the 14 th day after operation and used color Doppler utrasonography to diagnosis of DVT.Result:In the observation group,there were excellent in 17 cases,good in 11 cases,fair in 3 cases and no poor,with the good rate of 90.3%.In the control group,there were excellent in 19 cases,good in 8 cases,fair in 2 cases and poor in 2 cases,with the good rate of 87.1%.There were no statistics differences in excellent and good rate,DVT incidence rate between the two groups(P>0.05).There were no severe bleeding in both groups during treatment.Conclusion:Both Alprostadil combined with Salvianolate Injection or use LMWH singly has low incidence of DVT,which is worthy of clinical promotion.