摘要
目的观察红桃消肿合剂对下肢骨折患者手术后血流动力学、血栓前状态指标、机体免疫功能以及血清炎性因子水平的影响。方法将进行手术治疗的150例下肢骨折患者随机分为对照组75例和观察组75例。对照组患者服用安慰剂,观察组患者服用红桃消肿合剂,比较2组患者术后血流动力学指标、血栓前状态分子标志物水平、细胞免疫功能以及炎性因子肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)和IL-6水平变化,同时观察下肢深静脉血栓(DVT)的发生情况。结果术后第3天,2组患者全血黏度高切、毛细管血黏度、红细胞聚集指数、血清纤维蛋白原(FIB)和血管性血友病因子(v WF)水平均较术前显著升高(P均<0. 05),活化部分凝血活酶时间(APTT)较术前延长(P均<0. 05),D-二聚体含量较术前降低(P均<0. 05),免疫功能受到抑制,TNF-α和IL-2水平明显升高(P均<0. 05)。术后14 d,观察组患者全血黏度低切、全血黏度高切、毛细管血黏度、红细胞聚集指数以及v WF均明显低于术后3 d和对照组(P均<0. 05),且PT、APTT和CD4+、CD8+、CD4+/CD8+均明显改善,与术后3 d和对照组相比差异均有统计学意义(P均<0. 05); TNF-α和IL-2水平均明显低于术后3 d(P均<0. 05)。对照组和观察组分别有21例(28. 0%)和7例(9. 33%)患者出现DVT,观察组DVT发生率明显低于对照组(P <0. 05)。结论红桃消肿合剂可以改善下肢手术患者术后血液高凝、高黏状态,降低DVT的发生率,同时具有显著的抗炎消肿作用,值得临床推广。
Objective It is to observe the effects of Hongtao Xiaozhong Mixture on hemodynamics, prethrombotic state, immune function and serum inflammatory factors in patients with lower extremity fractures. Methods 150 patients with lower extremity fractures who underwent surgery were randomly divided into control group （ n =75 cases） and observation group （ n =75 cases）. The patients in the control group were treated with placebo. The patients in the observation group were treated with Hongtao Xiaozhong Mixture. The changes of hemodynamic parameters, molecular markers of prethrombotic state, cellular immune function and the levels of tumor necrosis factor alpha （TNF-α）, interleukin 2 （IL-2） and IL-6 were compared between the two groups, and the occurrence of deep venous thrombosis （DVT） of the lower extremities was observed. Results On the 3rd postoperative day, the blood viscosity, capillary viscosity, erythrocyte aggregation index, the levels of serum fibrinogen （FIB） and von Willebrand factor （vWF） of the two groups were significantly higher than those before operation （ P 〈0.05）, the activated partial thromboplastin time （APTT） was longer than that before operation（ P 〈0.05）, the content of D-dimer was lower than that before operation（ P 〈0.05）; at the same time, immune function was inhibited, the levels of TNF-α and IL-2 were significantly increased（ P 〈0.05）. On the 14th day after operation, the hemodynamic parameters of the observation group were significantly improved. The whole blood viscosity was lower, the whole blood viscosity was higher, the capillary blood viscosity, the red blood cell aggregation index and vWF were lower in the observation group than those on the 3rd postoperative day and in the control group （ P 〈0.05）, furthermore, PT, APTT and CD4 ＋, CD8 ＋, CD4 ＋/CD8 ＋ were significantly improved, and there was a statistical difference compared with those on the 3rd postoperative day and in the control group （ P 〈0.05）; the lev
作者
贾斌
李伟
刘彦勋
涂益鸿
李郑林
张勇
高彦军
张军波
JIA Bin;LI Wei;LIU Yanxun;TU Yihong;LI Zhenglin;ZHANG Yong;GAO YanJun;ZHANG Junbo(Shenzhen Pingle Orthopaedic Hospital,Shenzhen 518000,Guangdong,China)
出处
《现代中西医结合杂志》
CAS
2018年第34期3778-3781,3798,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
红桃消肿合剂
下肢骨折
围手术期
深静脉血栓
血栓前状态
Hongtao Xiaozhong Mixture
lower limb fracture
perioperative period
deep vein thrombosis
prethrombotic state
