替罗非班预防颅脑创伤术后静脉血栓栓塞症65例临床评价

摘要

Objective To observe the Preventive effect and safety of tirofiban for treating PostoPerative venous thromboembolism in Pa-tients with cerebral trauma. Methods 130 PostoPerative in Patients with cerebral trauma from January 2014 to January 2015 were ran-domly divided into the observation grouP and the control grouP,65 cases in each grouP. After oPeration,the control grouP used low molecular weight heParin calcium injection,the observing grouP selected tirofiban by intravenous infusion,the treatment course was 14d. Results The incidence of PostoPerative venous thromboembolism in the observation grouP was 1. 54%,which was lower than 10. 77%in the control grouP ( P 0. 05 ) ,the changes of the TEG index in the two grouPs after 14d had no statistical difference ( P > 0. 05 );the coag-ulation function index after 3d 14d of PT,APTT and TT D-dimer had no obvious difference ( P > 0. 05 ) ,and the PostoPerative co-agulation function index and D-dimer had no difference with before oPeration ( P > 0. 05 );the incidence of adverse reactions of the observation grouP was 7. 69%,which was lower than 15. 38% in the control grouP ( P < 0. 05). Conclusion The clinical Preventive ef-fect of tirofiban for treating PostoPerative venous thromboembolism in Patients with cerebral trauma is more obvious,and it does not af-fect the coagulation function of the body with less adverse reactions.%目的：探讨替罗非班对颅脑创伤术后静脉血栓栓塞症的预防作用及安全性。方法将2014年1月至2015年1月收治的拟行闭合性颅脑创伤手术后住院患者130例随机分为观察组和对照组，每组65例。手术后对照组采用低分子肝素钙注射液皮下注射，观察组采用盐酸替罗非班注射液静脉泵入，疗程均为14 d。结果观察组术后静脉血栓栓塞症发生率为1.54％，低于对照组的10.77％( P＜0.05)；两组术后血栓弹力图指标反应时间(R值)、凝固时间(K值)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及凝血酶时间( TT )指标均呈现先上升后下降的趋势，血栓最大幅度( Ma值)、凝固角(α值)及 D－二聚体指变化呈现均呈先降低后逐步升高的趋势，观察组波动幅度小于对照组，变化更为平稳，术后24 h、3 d两组以上指标较术前均具有统计学意义（ P＜0.05）。观察组不良反应发生率为7.69％，低于对照组的15.38％（ P＜0.05）。结论替罗非班用于预防颅脑创伤术后静脉血栓栓塞症临床效果更显著，不影响机体凝血功能，且不良反应更少。