[1]阮朝阳,曾强华,朱群威.丹参注射液预防全髋关节置换术后静脉血栓栓塞[J].中医正骨,2013,25(01):30-32.
　RUAN Zhao-yang*,ZENG Qiang-hua,ZHU Qun-wei..Clinical study on the curative effect and safety of DANSHEN injection in the prevention of venous thromboembolism after total hip arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(01):30-32.
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丹参注射液预防全髋关节置换术后静脉血栓栓塞()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期数:
2013年01期
页码:
30-32
栏目:
关节置换
出版日期:
2013-01-20

文章信息/Info

Title:
Clinical study on the curative effect and safety of DANSHEN injection in the prevention of venous thromboembolism after total hip arthroplasty
作者:
阮朝阳; 曾强华; 朱群威
浙江省海宁市人民医院,浙江 海宁 314400
Author(s):
RUAN Zhao-yang*; ZENG Qiang-hua; ZHU Qun-wei.
*The People's Hospital of Haining City,Haining 314400,Zhejiang,China
关键词:
静脉血栓形成 肺栓塞 丹参注射液 关节成形术; 置换; 髋 治疗; 临床研究性
Keywords:
Venous thrombosis;  Pulmonary embolism;  DANSHEN injection;  Arthroplasty; replacement; hip;  Therapies; investigational
摘要:
目的:观察丹参注射液预防全髋关节置换术后静脉血栓栓塞的临床疗效和安全性。方法:将纳入研究的132例需要进行全髋关节置换的患者分为2组,A组67例,B组65例。所有患者术前1 d停用促凝血药物。采用硬膜外麻醉; 术中处理股骨前,静脉注射肝素钠注射液15 U·kg-1,并彻底吸出股骨髓腔内容物; 处理股骨时,尽量缩短下肢保持在同一位置的时间; 术后立即开始使用周期性充气加压装置14 d,患肢穿弹力袜,同时鼓励患者尽早开始踝关节跖屈和背伸锻炼。A组患者从术后第1天开始静脉滴注丹参注射液(20 mL丹参注射液加入250 mL生理盐水),每天1次,连用14 d; B组患者从术后第1天开始皮下注射低分子肝素钙,每次0.4 mL,每天1次,连用14 d。观察比较2组患者术后静脉血栓栓塞的发生率,比较2组患者围手术期的出血量和血红蛋白下降值及术后血肿和胃肠道出血的发生率。结果:①临床疗效。A组1例患者发生非致命性肺血栓栓塞症,6例患者发生深静脉血栓形成; B组2例患者发生深静脉血栓形成。2组患者肺血栓栓塞症和深静脉血栓形成发生率组间比较,差异均无统计学意义(P=1.000; χ2=1.103,P=0.294)。②安全性。A组患者的围手术期出血量[(529.60±386.80)mL]和血红蛋白下降值[(33.04±17.03)g·L-1]与B组[(548.75±403.46)mL,(35.01±21.04)g·L-1]比较,差异均无统计学意义(t=0.783,P=0.474; t=1.292,P=0.193)。A组1例患者发生胃肠道出血; B组1例患者出现血肿,1例患者发生胃肠道出血。2组患者血肿及胃肠道出血发生率组间比较,差异均无统计学意义(P=0.492; P=1.000)。结论:丹参注射液预防全髋关节置换术后静脉血栓栓塞的疗效和安全性与低分子肝素相当。
Abstract:
Objective:To observe the clinical curative effect and safety of DANSHEN injection in the prevention of venous thromboembolism(VTE)after total hip arthroplasty(THA).Methods:One hundred and thirty-two patients considering THA were divided into 2 groups,67 cases in group A,while the others in group B.All the patients stopped using blood coagulant 1 day before the operation and epidural anesthesia was used during the operation.Heparin sodium injection(15 U/kg iv)was used before management of femur and the contents of femoral bone marrow cavity were sucked out completely.The time of keeping lower limbs in the same position was shortened as much as possible.The intermittent pneumatic compression device was immediately used after operation for 14 days,and the stretch socks were used for the affected limbs,and the patients were also encouraged to do ankle plantar flexion and dorsiflexion exercise as early as possible.Patients in group A were administrated with intravenous drip of DANSHEN injection(20 ml DANSHEN injection combined with 250 ml normal saline)from the 1st day after operation,once per day for 14 days,while the patients in group B were administrated with hypodermic injection of 0.4 ml low molecular weight heparin calcium injection from the 1st day after operation,once per day for 14 days.Such parameters were observed and compared between the 2 groups after the operation as the incidence rate of VTE,hematoma and gastrointestinal bleeding,the blood loss and hemoglobin loss during perioperative period.Results:One patient with non-lethal pulmonary thromboembolism(PTE)and 6 patient s with deep venous thrombosis(DVT)were found in group A,while 2 patients with DVT were found in group B.There were no statistical differences in the incidence rate of PTE and DVT between the 2 groups(P=1.000; χ2=1.103,P=0.294).There were no statistical differences in blood loss and hemoglobin loss between group A((529.60±386.80)ml,(33.04±17.03)g/l)and group B((548.75±403.46)ml,(35.01±21.04)g/l)respectively(t=0.783,P=0.474; t=1.292,P=0.193).One patient with gastrointestinal bleeding was found in group A,while 1 patient with hematoma and 1 patient with gastrointestinal bleeding were found in group B.There were no statistical differences in the incidence rate of hematoma and gastrointestinal bleeding between the 2 groups(P=0.492; P=1.000).Conclusion:DANSHEN injection is similar to low molecular weight heparin calcium in the curative effect and safety for prevention of venous thromboembolism after total hip arthroplasty.

参考文献/References:

[1] Heit JA,O'Fallon WM,Petterson TM,et al.Relative impact of risk factors for deep vein thrombosis and pulmonary embolism:a population-based study[J].Arch Intern Med,2002,162(11):1245-1248.
[2] Anderson FA Jr,Spencer FA.Risk factors for venous thromboembolism[J].Circulation,2003,107(23 Suppl 1):9-16.
[3] 林胜文,汪煌.彩色多普勒超声检查在下肢深静脉血栓形成诊断中的应用[J].中医正骨,2011,23(6):32-33.
[4] 邱贵兴,戴尅戎,杨庆铭,等.预防骨科大手术后深静脉血栓形成的专家建议[J].中华骨科杂志,2005,25(10):636-640.
[5] Dickson BC.Venous Thrombosis:On the History of Virchow's Triad[J].University of Toronto Medical Journal,2004,81(3):166-171.
[6] 邱贵兴,杨庆铭,余楠生,等.低分子肝素预防髋、膝关节手术后下肢深静脉血栓形成的多中心研究[J].中华骨科杂志,2006,26(12):819-822.
[7] Lotke PA.The role of aspirin for thromboembolic disease in total joint arthroplasty[J].Am J Knee Surg,1999,12(1):61-63.
[8] 章建华,童培建,袁临益,等.丹参注射液防治下肢深静脉血栓形成的实验研究[J].中医正骨,2005,17(9):3-4.
[9] Gomes MP,Deitcher SR.Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy:a clinical review[J].Arch Intern Med,2004,164(18):1965-1976.
[10] Rosendaal FR,Helmerhorst FM,Vandenbroucke JP.Female hormones and thrombosis[J].Arterioscler Thromb Vasc Biol,2002,22(2):201-210.
[11] Sharrock NE,Ranawat CS,Urquhart B,et al.Factors influencing deep vein thrombosis following total hip arthroplasty under epidural anesthesia[J].Anesth Analg,1993,76(4):765-771.
[12] Sharrock NE,Salvati EA.Hypotensive epidural anesthesia for total hip arthroplasty:a review[J].Acta Orthop Scand,1996,67(1):91-107.

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更新日期/Last Update: 2013-01-20