补中益气汤联合不同剂量低分子肝素钙在全髋关节置换术后下肢深静脉血栓形成预防中的应用研究

摘要

目的：观察补中益气汤联合不同剂量分子肝素钙对预防全髋关节置换术后下肢深静脉血栓的疗效。方法：将231例行单侧人工髋关节置换术患者随机分为补中益气汤组（A组）62例，补中益气汤+低分子肝素钙标准剂量组（B组）60例，补中益气汤+低分子肝素钙1/2剂量组（C组）53例，补中益气汤+低分子肝素钙1/4剂量组（D组）56例。A组患者于术后给予单纯补中益气汤，其余3组患者术后给予补中益气汤联合对应剂量低分子肝素钙，比较4组患者术后下肢深静脉血栓及不良反应的发生率，并于术后第14天检测患者血小板计数及凝血五项。结果：A组术后下肢深静脉血栓9例，发生率为14.52%；B组术后下肢深静脉血栓3例，发生率为5.00%；C组术后下肢深静脉血栓5例，发生率为9.43%；D组术后下肢深静脉血栓7例，发生率为12.50%。B组与各组比较，差异有统计学意义（P <0.05）。4组患者血小板计数及凝血五项比较，差异均无统计学意义（P >0.05）。结论：补中益气汤配合低分子肝素钙标准剂量预防髋关节术后深静脉血栓形成疗效确切，对凝血机制无影响，安全性好。%[ABSTRACT]Objective:To observe the curative effect ofBuzhong Yiqi Tang(补中℃气汤) combined with different doses of heparin calcium to prevent the form of lower extremity deep venous thrombosis after total hip arthroplasty.Methods:231 cases of patients with unilateral hip arthroplasty were randomly divided into aBuzhong Yiqi Tanggroup(group A,62 cases),aBuzhong Yiqi Tang+ low molecular weight heparin calcium standard dose group(group B,60 cases),aBuzhong Yiqi Tang + 1/2 low molecular weight heparin dose group(group C,53 cases),and aBuzhong Yiqi Tang + 1/4 low molecular weight heparin dose group(group D,56 cases).After operation,group A was treated withBuzhong Yiqi Tang,while the other 3 groups were treated withBuzhong Yiqi Tang combined with corresponding dose of low molecular heparin calcium,comparing the deep vein thrombosis of the lower extremity and the incidence of adverse reactions in the 4 groups and detecting the blood platelet count and the ifve items of thromboxane.Results:In group A,9 cases had postoperative lower extremity deep venous thrombosis,the incidence rate being 14.52%;in group B,3 cases had postoperative deep vein thrombosis,the incidence rate being 5%;in group C,5 cases had deep venous thrombosis of lower extremity after operation,the incidence rate being 9.43%;and in group D,postoperative deep vein thrombosis appeared in 7 cases,the incidence rate being 12.50%.The difference between group B and other groups was statistically significant(P < 0.05).The difference of the blood platelet count and the ifve items of thromboxane of the 4 groups was not statistically signiifcant (P > 0.05).Conclusion: Buzhong Yiqi Tang combined with low molecular weight heparin calcium has a curative effect in the prevention of postoperative hip deep vein thrombosis,safe,and with no effect on the blood coagulation mechanism.