利伐沙班联合血府逐瘀颗粒预防外科术后深静脉血栓形成的疗效观察

目的探讨利伐沙班联合血府逐瘀颗粒预防外科术后下肢深静脉血栓的疗效并探讨其可能的作用机制。方法选取2015年8月至2018年8月在青岛市市立医院接受外科手术治疗的患者200例,依据随机双盲的原则将患者分为观察组和对照组各100例。所有患者均接受手术治疗,观察组给予利伐沙班片+血府逐瘀颗粒,对照组给予低分子肝素钙皮下注射。两组术后均使用梯度压力袜及足底静脉泵等。观察两组治疗前和治疗第7d、14d后凝血功能:D-二聚体(D-Dimer, D-D)水平、纤维蛋白原(fibrinogen, FIB)浓度,活化部分凝血酶时间(activated partial throm boplastin time, APTT)及凝血酶时间(thrombin time, TT);比较两组静脉血栓发生率。结果治疗前2组患者血浆D-D、FIB、APTT、TT,比较差异均无统计学意义(P>0.05)。治疗7d、14d后D-D、FIB与治疗前比较均降低,且治疗14d后观察组血清D-D、FIB、水平较治疗后7d明显低于对照组(P<0.05)。两组患者治疗7d时血浆D-D、FIB水平及全血黏度均显著低于治疗7d (P<0.05)。预后两组D-D水平、 FIB均明显降低,且观察组明显低于对照组,差异具有统计学意义(P<0.05);两组APTT及TT均上升,且观察组显著高于对照组(P<0.05),观察组下肢深静脉血栓发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论利伐沙班联合血府逐瘀颗粒能够降低外科术后下肢深静脉血栓形成的发生率,值得推广。

Effect of rivaroxaban combined with xue fu zhu yu granules on prevention of venous thrombosis in the prevention of deep venous thrombosis after surgery

Objective To investigate the effi cacy of rivaroxaban combined with xuefuzhuyu granule in the prevention of deep venous thrombosis of lower extremity after surgery and explore the possible mechanism. Methods A total of 200 patients who received surgical treatment in our hospital from August 2015 to August 2018 were selected. All patients received surgical treatment, and the control group was given rivaroxaban tablets + xuefuzhuyu granules, The observation group was given subcutaneous injection of LMWH. Gradient pressure socks and plantar vein pumps were used in both groups after operation. The blood coagulation function of the two groups before treatment and after treatment at 7d and 14d were observed: d-dimer level (d-d), fi brinogen concentration (FIB), activated partial thrombin time (APTT) and thrombin time (TT). The incidence of venous thrombosis was compared between the two groups. Results Before treatment, there was no signifi cant difference in plasma d-d, FIB, APTT, TT between the two groups (P>0.05). The levels of d-d and FIB in the observation group were signifi cantly lower than those in the control group (all P<0.05). The plasma d-d, FIB level and whole blood viscosity of the two groups were signifi cantly lower than that of the patients treated for 7 days (P<0.05). The levels of d-d and FIB in the two groups were signifi cantly lower than those in the control group (P<0.05). APTT and PT increased in both groups, and the incidence of DVT in the observation group was signifi cantly higher than that in the control group (P<0.05), and the incidence of DVT in the observation group was signifi cantly lower than that in the control group (P<0.05). Conclusion Rivaroxaban combined with xuefuzhuyu granule can reduce the incidence of deep venous thrombosis after surgery, which is worthy of promotion.