摘要
目的观察脉络舒通丸联合利伐沙班对复杂胫骨平台骨折术后血栓形成的影响。方法选择2018年1月至2019年12月河北省唐山市第二医院创伤二科收治的复杂胫骨平台骨折术后患者115例,按随机数字表法将其分为对照组(57例)和观察组(58例)。对照组口服利伐沙班,观察组在对照组基础上加服脉络舒通丸,两组均治疗14 d。采用数字评分法(NRS)评价两组术前及术后1、3、7、14 d的疼痛情况。比较两组术前及术后1、3、7 d的凝血指标,包括凝血酶原时间(PT)、凝血酶凝固时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)和纤维蛋白原降解产物(FDP)水平。记录两组肿胀消退时间、深静脉血栓(DVT)和不良反应发生情况。结果两组术后1、3 d的NRS评分均高于术前,术后7、14 d的NRS评分均低于术前,术后3、7、14 d的NRS评分均低于术后1 d,术后7、14 d的NRS评分低于术后3 d,术后14 d的NRS评分均低于术后7 d(P<0.05)。观察组术后3、7、14 d的NRS评分均低于同期对照组(P<0.05)。两组术后1、3、7 d的FIB、D-D、FDP高于术前,两组术后3、7 d的FIB、D-D低于术后1 d,对照组术后3、7 d及观察组术后7 d的FDP均低于术后1 d,两组术后7 d的FIB、D-D、FDP均低于术后3 d(P<0.05)。观察组术后3、7 d的FIB、D-D、FDP低于同期对照组(P<0.05)。观察组肿胀消退时间短于对照组(P<0.05)。两组DVT发生率、不良反应总发生率比较,差异无统计学意义(P>0.05)。结论脉络舒通丸可改善患者凝血纤溶功能,有效预防复杂胫骨平台骨折术后血栓形成。
Objective To observe the effect of Mailuo Shutong Pills combined with Rivaroxaban on thrombosis after complex tibial plateau fracture operation.Methods A total of 115 postoperative patients with complex tibial plateau fractures admitted to the Second Department of Traumatology of the Second Hospital of Tangshan City,Hebei Province from January 2018 to December 2019 were selected,and they were divided into the control group(57 cases)and the observation group(58 cases)according to the random number table method.The control group was given Rivaroxaban orally,and the observation group was given Mailuo Shutong Pills on the basis of the control group,both groups were treated for 14 days.Numerical scoring method(NRS)was used to evaluate the pain of the two groups before operation and 1,3,7,14 d after operation.The levels of prothrombin time(PT),thrombin coagulation time(TT),activated partial thrombin time(APTT),fibrinogen(FIB),fibrinolytic index D-dimer(D-D),and fibrinogen degradation product(FDP)were compared between the two groups before operation and 1,3,7 d after operation.The time of swelling subside,deep venous thrombosis(DVT),and adverse reactions were recorded.Results The NRS scores of both groups at 1,3 d after operation were higher than those before operation,NRS scores of both groups at 7,14 d after operation were lower than those before operation,NRS scores of both groups at 3,7,14 d after operation were lower than those at 1 d after operation,NRS scores of both groups at 7,14 d after operation were lower than those at 3 d after operation,NRS scores of both groups at 14 d after operation were lower than those at 7 d after operation(P<0.05).NRS scores of observation group at 3,7,14 d after operation were lower than control group at the same time points(P<0.05).The FIB,D-D,and FDP of the two groups at 1,3,7 d after operation were higher than those before operation,and the FIB and D-D of the two groups at 3,7 d after operation were lower than those at 1 d after operation,FDP of the control group at 3,7 d after operation and FDP of the observation group at 7 d after operation were both lower than those at 1 d after operation,the FIB,D-D,and FDP of both groups at 7 d after operation were lower than those at 3 d after operation(P<0.05).The FIB,D-D,and FDP of observation group were lower than those of control group at 3,7 d after operation(P<0.05).The time of swelling subside in observation group was shorter than that in control group(P<0.05).There were no significant differences in the incidence of DVT and total incidence of adverse reactions between the two groups(P>0.05).Conclusion Mailuo Shutong Pills could improve coagulation and fibrinolysis functions,and prevent the postoperative thrombus of complex tibial plateau fractures effectively.
作者
王爱军
陶建峰
WANG Aijun;TAO Jianfeng(The Second Department of Traumatology,the Second Hospital of Tangshan City,Hebei Province,Tangshan063000,China;the First Department of Joint,the Second Hospital of Tangshan City,Hebei Province,Tangshan063000,China)
出处
《中国医药导报》
CAS
2022年第21期95-98,114,共5页
China Medical Herald
基金
河北省医学科学研究重点课题(20160815)。
关键词
脉络舒通丸
复杂胫骨平台骨折
血栓
凝血
纤维蛋白溶解
Mailuo Shutong Pills
Complex tibial plateau fractures
Thrombus
Coagulation
Fibrinolysis
