摘要
目的探讨脉络舒通颗粒预防人工膝关节置换（tTKA）术后下肢深静脉血栓形成（DVT）的疗效及初步机制。方法216例接受单侧TKA的患者入院时随机分为3组，分别给予脉络舒通颗粒、低分子肝素及利伐沙班至术后2周。选择临床症状、凝血及鸡尾酒监测指标、超声探查、肺捡塞（PE）发生率、副作用为对比依据，比较脉络舒通、低分子肝素及利伐沙班预防TKA术后DVT的疗效。结果3组药物对凝血功能的影响无明显差异。脉络舒通组小腿肿痛及皮肤瘀斑发生率最低，纤维蛋白原升幅脉络舒通组与低分子肝素相当，利伐沙班组升幅最小。基于下肢超声及鸡尾酒监测的筛查，脉络疏通与低分子肝素钙组DVT发生率均为4．17％（3／72），略高于利伐沙班组2．78％（2／72）。各药物干预组及总体PE发生率均为1．39％（1／72，3／216），无致命性PE发生。结论对于 TKA术后DVT的预防，脉络舒通给药方便，副作用小，疗效安全可靠，能减轻患者痛苦及经济负担，与物理预防联合应用可以替代传统的低分子肝素。
Objective To investigate the effects and mechanism of Mailuoshutong against deep vein thrombosis（DVT） after total knee arthroplasty（ TKA）. Methods Two hundred and sixteen patients who were treated with TKA were randomly divided into three groups, and separately treated with Mailuoshutong,low molecular weight heparin（LMWH） and rivaroxaban for two weeks ＇after operation. Choose clin- ical symptoms, change of blood coagulation, cocktail monitoring index, ineidenee rate of DVT under Doppler, occurrence rate of pulmonary, em- bolism （ PE ） and side effects for contrasting basis to compare prophylaxis eftets against DVT among the three groups. Results＇ The effects of drugs on blood eoagulation had no signifieant difference in three groups. Mailuoshutong group had less incidence of leg swelling,pain and pe- teehial hemorrhage. Fibrinogen increase rate in Mailuoshutong group was the same as that in LMWH group,and higher than that in Rivaroxa- ban group. Based on screening of Doppler ultrasound of lower limb and cocktails monitoring, the ineidences of DVT were 4. 17% （3/72） in the group of Mailuoshutong and LMWH, slightly higher than that in the rivaroxaban group whieh were 2.78% （2/72）. Every group and the o- verall ineidenees of PE were 1.39% （ 1/72,3/216） and no fatal PE occurred. Conclusion Mailuoshutnng was a potential therapeutic means for prophylaxis against DVT after TKA.
出处
《潍坊医学院学报》
2012年第5期347-350,共4页
Acta Academiae Medicinae Weifang
