摘要
目的 观察低分子肝素序贯阿司匹林对单侧髋或膝关节置换术后患者的治疗效果及下肢深静脉血栓(DVT)形成的影响.方法 收集2021年6月至2023年6月在内蒙古医科大学附属医院行单侧髋或膝关节置换术的80例患者进行前瞻性研究,按照随机数字表法分为观察组(n=40)与对照组(n=40),分别采用低分子肝素序贯阿司匹林治疗与单一低分子肝素治疗.于治疗前及治疗后2周检测凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)]、下肢静脉血流指标(下肢静脉血流峰速度、平均血流量及血流速度)、炎症因子[高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平,随访术后DVT发生情况.结果 治疗后2周,观察组的PT、APTT、水平分别为(12.66±1.98)、(37.74±6.58)s,均明显高于对照组[(10.35±0.62)、(33.58±6.26)s],Fg 为(3.59±1.09)g/L,明显低于对照组[(4.88±0.71)g/L],差异均有统计学意义(P＜0.05).治疗后2周,观察组下肢静脉血流峰速度、平均血流量及血流速度分别为(14.74±2.16)cm/s、(24.46±2.63)cm/s、(8.63±1.06)mL/s,均高于对照组[(12.42±2.08)cm/s、(22.15±1.84)cm/s、(7.35±1.14)mL/s],差异均有统计学意义(P＜0.05).观察组治疗后2周的血清hs-CRP、IL-6水平分别为(9.13±1.92)mg/L、(25.13±2.92)pg/mL,均低于对照组[(15.15± 2.46)mg/L、(37.15±3.46)pg/mL],差异均有统计学意义(P＜0.05).观察组患者术后DVT发生率为5.00％,明显低于对照组(20.00％),差异有统计学意义(P＜0.05).结论 低分子肝素序贯阿司匹林治疗方案,可改善单侧髋或膝关节置换术后患者凝血功能,降低炎症因子水平,预防DVT的发生.
Abstract
Objective To observe the effect of low molecular heparin sequential aspirin on the treatment of patients with unilateral hip or knee replacement and the formation of lower limb deep vein thrombosis(DVT).Methods A prospective study were conducted on 80 patients who underwent unilateral hip or knee arthroplasty in Affiliated Hospital of Inner Mongolia Medical University from June 2021 to June 2023.They were randomly divided into the observation group(n=40)and the control group(n=40)according to random number table method.Low mo-lecular weight heparin sequential aspirin treatment and single low molecular weight heparin treatment were used,respectively.The coagulation in-dicators[prothrombin time(PT),activated partial thromboplastin time(APTT),prothrombin time(PT)],lower limb venous blood flow indica-tors(lower limb venous peak velocity,mean blood flow,and blood flow velocity),levels of inflammatory factors[(high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)]were measured before and 2 weeks after treatment.Postoperative DVT incidence were followed up.Results Two weeks after treatment,the levels of PT and APTT in two groups were higher those before treatment,while the levels of Fg were lower those before treatment,the levels of PT and APTT in the observation group were(12.66±1.98)and(37.74±6.58)s,respectively,which were significantly higher than those in the control group[(10.35±0.62)and(33.58±6.26)s],Fg was(3.59±1.09)g/L,which was sig-nificantly lower than those in the control group[(4.88±0.71)g/L],and the differences were statistically significant(P＜0.05).Two weeks after treatment,lower limb venous peak velocity,mean blood flow,and blood flow velocity of the lower limb venous blood flow in the observation group were(14.74±2.16)cm/s,(24.46±2.63)cm/s,and(8.63±1.06)mL/s,respectively,which were higher than those in the control group[(12.42±2.08)cm/s,(22.15±1.84)cm/s,and(7.35±1.14)mL/s],and the differences were statistically significant(P＜0.05).Two weeks after treatment,the levels of serum hs-CRP and IL-6 in the observation group were(9.13±1.92)mg/L and(25.13±2.92)pg/mL,respectively,which were lower than those in the control group[(15.15±2.46)mg/L and(37.15±3.46)pg/mL],and the differences were statistically significant(P＜0.05).The incidence of postoperative DVT in the observation group were 5.00％,which was significantly lower than that in the control group(20.00％),and the difference were statistically significant(P＜0.05).Conclusion The low molecular heparin sequential aspirin treatment regimen can improve coagulation function,reduce inflammatory factor levels,and prevent the occurrence of DVT in pa-tients after unilateral hip or knee arthroplasty.
基金项目
内蒙古自治区自然科学基金项目(2020LH08027)
NETL
NSTL
维普
万方数据