加味桃红四物汤口服减少全髋关节置换术后低分子肝素钙用量的临床观察.docVIP

加味桃红四物汤口服减少全髋关节置换术后低分子肝素钙用量的临床观察 　　【摘 要】目的：观察加味桃红四物汤联合低剂量低分子肝素钙减少全髋关节置换术后下肢深静脉血栓形成的临床疗效。方法：将78例初次接受单侧全髋关节置换手术的患者随机分为治疗组38例和对照组40例。治疗组从术前1 d开始口服加味桃红四物汤（每次150 mL，每日2次），联合低剂量低分子肝素钙皮下注射（1/2正常剂量，每日1次）；对照组从术前1 d开始低分子肝素钙皮下注射（正常剂量，每日1次）。均持续至术后第14天。术后第14天检测患者外周血凝血功能、血小板计数，常规行双下肢静脉彩色多普勒超声检查。记录患者术后下肢深静脉血栓发生情况及治疗期间不良反应发生情况。结果：治疗组发生下肢深静脉血栓2例，对照组发生下肢深静脉血栓4例，2组发生率比较，差异无统计学意义 　　（P 0.05）。2组患者手术时间比较，差异无统计学意义（P 0.05）；与对照组比较，治疗组术中出血少、输血少、下床时间早（P 0.05），但治疗组较对照组肿胀轻。2组患者术后第14天凝血酶原时间、血小板计数、血浆D-二聚体比较，差异无统计学意义（P 0.05）；与对照组比较，治疗组活化部分凝血活酶时间延长，差异有统计学意义 　　（P 0.05）。结论：运用加味桃红四物汤联合低剂量低分子肝素钙能减少全髋关节置换术后低分子肝素钙用量，降低术后下肢深静脉血栓发生率。 　　【关键词】 全髋关节置换术；下肢深静脉血栓；加味桃红四物汤；低分子肝素钙 　　Clinical Observation on Modified Taohong Siwu Tang（加味桃红四物汤）Reducing the Amount of Low Molecular Heparin Calcium after Total Hip Arthroplasty 　　ZHANG Hai-long，WANG Shao-hui，LI Rui，ZHANG Hong-jun 　　【ABSTRACT】Objective：To observe the clinical effect of modified Taohong Siwu Tang（加味桃红四物汤） 　　combined with low dose of low molecular heparin calcium on the decrease of deep venous thrombosis formation in lower extremity after total hip arthroplasty.Methods：Seventy eight patients with initial total hip arthroplasty were randomly divided into a treatment group（38 cases）and a control group（40 cases）.One day before treatment，patients in the treatment group orally took Taohong Siwu Tang（150 mL each time and 2 times a day）and were given subcutaneous injections of low dose of low molecular heparin calcium（1/2 of the normal dose，once daily）；while the control group was only given subcutaneous injections of low molecular heparin calcium（normal dose，once daily）.All patients were treated till the fourteenth day after surgery.The blood coagulation function and platelet count were detected after fourteenth day of operation，and the color Doppler ultrasonography was performed in the patients for lower limb vein.The incidence of deep venous thrombosis of lower extremity after operation and the occurrence of adverse reactions during treatment were rec