疏血通对髋部骨折患者凝血-纤溶功能影响的临床研究

A Clinical Study on the Changes of Coagulation-fibr inolysis System in the Patients Under going Fracture of Hip Receiving Treatment of Shuxuetong Complex

目的:评估疏血通对髋关节手术患者术后凝血-纤溶系统的影响。方法:选择2002年7月～2003年4月髋部手术患者共57例,根据入院时间穴单双日雪分为治疗组穴34例雪和对照组穴23例雪,手术前3d开始分别采用疏血通和低分子肝素治疗,共10d,于用药前、术前、术后第1天、术后第3天、术后第7天,测定白陶土部分凝血活酶时间穴KPTT雪、凝血酶原时间穴PT雪、组织型纤溶酶原激活剂穴t-PA雪、组织型纤溶酶原激活剂抑制剂穴PAI雪、D-dimer、血小板聚集率,怀疑有深静脉血栓穴DVT雪者行静脉造影检查。结果:两组治疗前后KPTT,PT明显延长;治疗组t-PA活性明显增强穴P<0.05雪,D-dimer升高,PAI无明显变化,并抑制血小板聚集。结论:疏血通在预防和治疗髋关节术后静脉血栓形成中,不仅有抗凝作用,而且能激活纤溶系统,抑制血小板聚集,是一种安全有效的药物。

Objective:To investigate the change o f coagulation-fibrinolysis system in the postoperative patients undergoing fractu re of hip receiving treatment of Shuxuetong complex.Methods:In57consecutive patients undergoing fracture of hip between July2002and April2003were ra ndomly divided into treatment group(n=34)and control group(n=23).Trea tment group administrated Shuxuetong complex and control group adjusted dose sub cutaneous low molecular heparin calcium.In the day before administration,the d ay of preoperative and the1st,3rd,7th day of postoperative period,we deter mined KPTT,PT,t-PA,PAI,D-dimer and platelet aggregation level.Venography was be used to diagnose deep venous thromboses(DVT).Results:5of34(14. 7%)patients had venographically evident DVT in the treatment group and4of2 3(17.4%)in control group.In both groups,DVT decreased after administra tion,KPTT and PT were prolonged.But in treatment group,t-PA activity and D-dimer level increased,mean while the platelet aggregation was inhibited markedl y.There was no significant change of PAI activity.Conclusion:The prophylaxis and therapeutic effect and mechanism of Shuxuetong complex are related to inhibi tion of platelet aggregation,anticoagulation and activation of fibrinolysis in patients under going fracture of hip.