丹参川芎嗪联合烫疗对预防人工髋关节置换术后深静脉血栓的临床研究

Clinical Study on Preventive Effect of Salvia Miltiorrhiza and Ligustrazine Combined with Scalding Therapy on Deep Venous Thrombosis after Artificial Hip Arthroplasty

目的:观察比较人工髋关节置换术后利用丹参川芎嗪联合中药烫疗预防下肢深静脉血栓形成的疗效和安全性。方法 :对2015年9月—2017年9月我院收治的60例髋关节置换术患者采用随机数字表法分为治疗组和对照组,各30例。治疗组术后给予丹参川芎嗪注射液(5 mL+0.9%氯化钠注射液250 mL,静脉滴注,qd)及瑶药烫疗包烫疗患肢(烫疗15分钟,每次使用2个烫疗包,bid),对照组术后给予低分子肝素钙注射液(0.4 mL皮下注射,qd),比较两组血小板计数、凝血三项、引流管引流量及术后下肢深静脉血栓的发生率。结果 :两组术后第7天血小板计数高于术前、术后第1、3、14天,且对照组高于治疗组,差异有统计学意义(P <0.05)。术后第14天两组血小板计数与术前比较,差异无统计学意义(P> 0.05);术后1、3、7天两组凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)高于术前,差异有统计学差异(P <0.01或<0.05);术后1、3、7天两组D-二聚体高于术前,且术后7天对照组高于治疗组,差异有统计学意义(P <0.05或<0.01);术后14天两组PT、APTT、D-二聚体与术前及组间比较,差异无统计学意义(P> 0.05);两组术后引流量比较,差异无统计学意义(P> 0.05);两组术后3、14天及出院后4周复查下肢静脉彩超均未发现下肢深静脉血栓形成。结论 :丹参川芎嗪注射液静滴联合我院瑶药烫疗包烫疗可有效预防髋关节术后下肢深静脉血栓形成,且价格低廉、安全性高。

Objective:To observe the efficacy and safety of Salvia miltiorrhiza and ligustrazine combined with scalding therapy in the prevention of deep venous thrombosis of lower extremities after artificial hip arthroplasty.Methods:60 patients who underwent hip arthroplasty admitted to our hospital from September 2015 to September 2017 were randomly divided into a treatment group and a control group,30 cases each.The patients in the treatment group were given Salvia miltiorrhiza and ligustrazine injection(5 mL+0.9%sodium chloride injection 250 mL,intravenous drip,qd)and Yao medicine scalding packages to treat the affected extremities(scalding for 15 minutes,2 packages per time,bid).The patients in the control group were given low molecular weight heparin calcium injection(0.4 mL subcutaneous injection,qd).The platelet count,three items of blood coagulation,drainage amount from drainage tube and the incidence of postoperative deep venous thrombosis of low extremities were compared between the two groups.Results:The platelet count on the 7 th day after surgery was higher than that on the 1 st,3 rd and 14 th day after surgery in the two groups,and the platelet count in the control group was higher than that in the treatment group,with statistically significant differences(P<0.05).There was no statistically significant difference in the platelet count on the 14 th day after surgery between the two groups(P>0.05).The prothrombin time(PT)and activated partial prothrombin time(APTT)on the 1 st,3 rd and 7 th day after surgery were higher than those before surgery in the two groups,and the differences were statistically significant(P<0.01 or<0.05).The level of D-dimer on the 1 st,3 rd and 7 th day after surgery was higher than that before surgery in the two groups,and the level on the 7 th day after surgery in the control group was higher than that in the treatment group,with statistically significant differences(P<0.05 or<0.01).There were no statistically significant differences in PT,APTT and D-dimer on the 14 th day after surgery compared with those before surgery and between the two groups(P>0.05).There was no statistically significant difference in postoperative drainage amount between the two groups(P>0.05).There were no deep venous thrombosis of lower extremities in color Doppler ultrasonograms about on the 3 rd and14 th days after surgery and 4 weeks after discharge.Conclusion:Salvia miltiorrhiza and ligustrazine injection combined with scalding therapy with Yao medicine scalding packages from our hospital can effectively prevent deep venous thrombosis of lower extremities after hip joint surgery,and is low in price and safe.