摘要
目的探讨低分子肝素钙联合双嘧达莫治疗对下肢骨折患者术后血清D-二聚体(D-D)水平及预防血栓形成(DVT)的临床效果。方法选择我院收治的138例下肢骨折患者,按照随机数字表法分为对照组68例和联合组70例,手术后分别应用双嘧达莫方案、双嘧达莫联合低分子肝素钙方案,用药10天后,比较两组DVT发生率和术后引流量、双下肢周径差、凝血功能和血清血小板衍生生长因子(PDGF)、血管细胞黏附分子1(VCAM-1)、高迁移率蛋白1(HMGB1)水平,并进行安全性评价。结果联合组DVT发生率低于对照组(P<0.05),两组术后12、24、48 h引流量比较差异无统计学意义(P>0.05);两组患侧与健侧的大腿周径差及小腿周径差水平均较用药前降低,且联合组低于对照组(P<0.05);两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)延长,纤维蛋白原(FIB)、D-D水平降低,且联合组APTT、PT时间长于对照组,FIB、D-D水平低于对照组(P<0.05);两组PDGF水平升高,s VCAM-1、HMGB1水平降低,且联合组PDGF水平高于对照组,s VCAM-1、HMGB1水平低于对照组(P<0.05);两组用药期间不良反应发生率比较差异无统计学意义(P>0.05)。结论低分子肝素钙联合双嘧达莫能够改善下肢骨折患者术后患肢肿胀、凝血功能,有效预防术后DVT的发生,有助于骨折愈合,用药安全。
Objective To explore the clinical effects of low molecular weight heparin calcium combined with dipyridamole on postoperative serum D-Dimer(D-D)level and prevention of deep venous thrombosis(DVT)in patients with lower limb fractures.Methods One hundred and thirty-eight patients with lower limb fractures admitted to our hospital were selected.The patients were randomly divided into a control group(n=68)and a combined group(n=70).After surgery,dipyridamole regimen and regimen of dipyridamole combined with low molecular weight heparin calcium were applied,respectively.After 10 days of medication,the incidence rate of DVT and postoperative drainage volume,circumference difference of lower limbs,coagulation function,and levels of serum plateletderived growth factor(PDGF),vascular cell adhesion molecule-1(VCAM-1),and high mobility protein B 1(HMGB1)were compared,and the safety evaluation was performed.Results After medication,the incidence rate of DVT in the combined group was significantly lower than that in the control group(P<0.05).There was no statistical significance in the drainage volume at 12 h,24 h and 48 h after surgery between the two groups(P>0.05).The circumference difference of the thigh and the circumference difference of the calf between the affected side and the healthy side were significantly reduced in both groups(P<0.05),and the above two indicators of the combined group were lower than those of the control group(P<0.05).The activated partial thromboplastin time(APTT)and prothrombin time(PT)of both groups were significantly prolonged(P<0.05),and the levels of fibrinogen(FIB)and D-D were significantly decreased(P<0.05).The APTT and PT in the combined group after medication were significantly longer than those in the control group(P<0.05).The levels of FIB and D-D in the combined group were significantly lower than those in the control group(P<0.05).The PDGF level of the two groups was significantly increased(P<0.05)while the levels of sV CAM-1 and HMGB1 were significantly decreased(P<0.05),and the PD
作者
陈琳
张双
笪俊
李文
CHEN Lin;ZHANG Shuang;DA Jun;LI Wen(Department of Orthopedics,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)
出处
《实用医院临床杂志》
2021年第6期118-121,共4页
Practical Journal of Clinical Medicine
基金
四川省卫生健康委员会科研基金资助项目(编号:20PJ141)。
关键词
低分子肝素钙
双嘧达莫
下肢骨折
D-二聚体
血栓形成
Low molecular weight heparin calcium
Dipyridamole
Lower limb fractures
D-Dimer
Thrombosis
