香豆乙酯联合华法林治疗重度烧伤后并发下肢深静脉血栓形成的临床观察

目的研究香豆乙酯联合华法林治疗重度烧伤患者并发下肢深静脉血栓形成(DVT)的临床疗效。方法选取我院2015年4月至2016年4月因重度烧伤并发下肢DVT的患者60例,随机分为对照组和观察组各30例,对照组给与常规抗血栓药物华法林钠片口服治疗;实验组在对照组的基础上加用香豆乙酯口服;两组患者在治疗前以及治疗后1 d,3 d,6 d采集静脉血样,测定部分凝血活酶时间(a PTT),凝血酶时间(TT),凝血酶原时间(PT)以及D二聚体以及纤维蛋白并使用血管彩色超神检测患者下肢DVT溶解率;出血率以及血栓的复发率。结果治疗前后两组患者的凝血功能;血栓溶解率;出血率均较低且观察组的总出血率较对照组低(P0.05);血栓的复发率两组均有下降且观察组的下降程度明显优于对照组(P0.05);观察组的总有效率为93.3%较对照组66.7%高。结论香豆乙酯联合华法林治疗重度烧伤后并发下肢DVT有良好的疗效,可改善患者的凝血功能和出血率,提高血栓的溶解率并能降低血栓的复发率。

Clinical Study on the Treatment of deep Venous Thrombosis of the Lower Extremity after Severe burn with Ethyl Ester and Warfarin

Objective To study the clinical effect of the combination of ethyl ethyl ester and warfarin in the treatment of severe burn patients with lower extremity deep venous thrombosis ( DVT) .Methods In our hospital in April 2015 April-2016 years for 60 cases of severe burn complicated with DVT of lower extremity were randomly divided into control group and observation group with 30 cases in each group ,the control group given conventional antithrombotic drugs Warfarin Sodium Tablets oral treatment;the experimental group were treated with ethyl biscoumacetate orally on the basis of the control group;two patients in group before and after the treatment of 1 d,3 d,6 d venous blood samples were collected for determination of partial thromboplastin time(aPTT),thrombin time(TT),prothrombin time(PT)and D-dimer(D-D)and fibrinogen(Fbg)and the use of color super detection in patients with vascular dissolution of lower extremity DVT rate;bleeding rate and the recurrence rate of thrombosis .Results The results of blood coagulation function in the patients of the two groups before and after treatment;thrombolytic rate;bleeding rate was lower in the observation group the total bleeding rate is lower than the control group ( P<0.05);the recurrence rate of thrombosis in two groups were decreased and the observation group decreased significantly than the control group ( P<0.05 );the observation group total efficiency is 93.3% higher than the control group 66.7%.Conclusion ethyl biscoumacetate combined with warfarin in the treatment of severe burn complicated with DVT has good curative effect , can improve the function of blood coagulation and bleeding rates in patients with thrombosis , improve the dissolution rate and can reduce the recurrence rate of thrombosisn .