三七粉联合低分子量肝素钙预防下肢静脉曲张术后深静脉血栓形成疗效观察

摘要

Objective It is to observe the clinical efficacy of Panax notoginseng powder combined with low molecular weight heparin calcium in prevention of deep venous thrombosis (DVT) after surgery for varicose veins of lower extremity.Methods 73 patients after surgery for varicose vein of lower extremity were randomly divided into two groups,the experimental group (n =37) was treated with Panax notoginseng powder combined with low molecular weight heparin calcium,the control group (n =36) was treated with low molecular weight heparin calcium.The levels of plasma D-dimer (D-D),fibrinogen (FIB),prothrombin time (PT),activated partial thromboplastin time (APTT) were detected before operation and in 3,7 days after operation in both groups,the incidence of DVT and occurrence of side effects were observed.Results There was no significant difference in plasma D-D,FIB,PT,APTT between the two groups before operation (P ＞ 0.05).In 3 days after operation,the levels of plasma D-D,FIB and PT,APTT were significantly higher than those before operation in both groups (P ＜ 0.05),but the differences were not significant between the two groups (P ＞ 0.05).In 7 days after operation,the levels of plasma D-D,FIB were lower,and PT,APTT were shorter than those in 3 days after operation,and the changes in the experiment group were more significantly than those in the control groups (P ＜ 0.05).The incidence of DVT in the experiment group was lower than that in the control group (P ＜ 0.05).No bleeding event and other side effect was found in both groups.Conclusion Panax notoginseng powder combined with low molecular weight heparin calcium could obviously every coagulation index after surgery for lower extremity varicose vein,decrease the incidence of postoperative DVT,with low risk of bleeding,it is worthy of popularization and application.%目的 观察三七粉联合低分子量肝素钙预防下肢静脉曲张术后深静脉血栓形成(DVT)的临床疗效.方法 将73例符合研究标准的下肢静脉曲张术后患者随机分成2组,实验组37例给予三七粉联合低分子量肝素钙治疗,对照组36例给予低分子量肝素钙治疗,检测2组患者术前和术后3d、7d血浆D-二聚体(D-D)、纤维蛋白原(FIB)水平和凝血酶原时间(PT)、部分凝血活酶时间(APTT),统计2组术后DVT发生率及不良反应发生情况.结果 术前2组患者血浆D-D、FIB、PT、APTT比较差异均无统计学意义(P均＞0.05).术后3d,2组患者血浆D-D、FIB水平及PT、APTT均明显高于术前(P均＜0.05),但2组间比较差异均无统计学意义(P均＞0.05).术后7d,2组患者血浆D-D、FIB水平均明显低于术后3d(P均＜0.05),且实验组明显低于对照组(P均＜0.05);APTT、PT均明显长于术后3d(P均＜0.05),且实验组明显长于对照组(P均＜0.05).实验组DVT发生率明显低于对照组(P＜0.05),2组均未发生出血及其他不良反应.结论 三七粉联合低分子量肝素钙可明显改善下肢静脉曲张术后各项凝血指标,降低术后DVT发生率,且出血风险低,值得推广应用.