中西药联合治疗预防下肢骨折术后深静脉血栓形成的疗效及机制研究

摘要

目的：探讨丹参注射液联合利伐沙班预防下肢骨折术后深静脉血栓形成（DVT ）的疗效及机制。方法将120例符合纳入标准的下肢骨折术后患者分为对照组和观察组，每组各60例患者。所有患者均给予常规治疗，对照组在常规治疗的基础上给予丹参注射液治疗，观察组在对照组的基础上联合使用利伐沙班治疗。比较两组患者 DVT 发病率，以及治疗前后 DVT 早期诊断指标[D‐二聚体、同型半胱氨酸、C 反应蛋白（CRP）]和血液流变学指标（红细胞比容、全血黏度、纤维蛋白原）的水平。结果观察组 DVT 发病率为10．0％，明显低于对照组41．7％的 DVT 发病率（P＜ 0．05）。与对照组相比，术后3 d 观察组 D‐二聚体、同型半胱氨酸和 CRP 水平明显降低，且治疗后红细胞比容、全血黏度和纤维蛋白原水平亦低于对照组（P ＜ 0．05）。结论丹参注射液联合利伐沙班治疗可改善下肢骨折患者术后血液高凝状态，从而有效预防下肢骨折术后 DVT 的发生，值得进一步研究。%Objective To investigate the clinical effect and mechanism of combined treatment of Danshen injec‐tion and rivaroxaban for the prevention of deep venous thrombosis (DVT ) after operation of lower limb fracture . Methods A total of 120 cases with operation of lower limb fracture ,meeting the inclusion critera ,were divided into two groups equally .Patients of control group were treated with Danshen injection and those of observation group were treated with Danshen injection and rivaroxaban .The incidence of DVT ,early diagnostic indices of DVT ,inclu‐ding D‐dimmer ,homocysteine and C reaction protein (CPR) ,and hemorheology indices ,including hematocrit ,whole blood viscosity and fibrinogen ,were compared between the two groups .Results The incidence of DVT of observation group was 10 .0% ,higher than the 41 .7% of control group (P < 0 .05) .Three days after operation ,levels of D‐di‐mer ,homocysteine and CRP in observation group were significantly lower than control group ,and after treatment , levels of hematocrit ,whole blood viscosity and fibrinogen in observation group were also significantly lower ( P <0 .05) .Conclusion Combined treatment of Danshen injection and rivaroxaban could improve hypercoagulabe state in patients after operation of lower limb fracture ,thus prevent the onset of DVT ,which might be worth for further in‐vestigation .