低频脉冲联合水蛭预防下肢骨折术后深静脉血栓形成的临床研究

目的：探讨低频脉冲联合水蛭预防下肢骨折术后深静脉血栓形成的临床疗效。方法：选取90例下肢骨折手术患者，随机分为3组，每组30例，术后分别给予低分子肝素、低分子肝素+水蛭、低分子肝素+水蛭+低频脉冲进行预防血栓治疗。比较各组术前、术后的凝血功能、血流动力学、彩超结果及下肢消肿时间。结果：对照组和水蛭组下肢肿胀开始消退时间分别为5.2±1.4d和5.4±1.3d，低频脉冲+水蛭组下肢肿胀开始消退时间为3.6±0.9d，低频脉冲+水蛭组明显低于其他两组 (P<0.05)；低频脉冲+水蛭组下肢肿胀的消除速度要明显快于其他两组 (P<0.05)； 低频脉冲+水蛭组术后7 d 股静脉血流速度要快于其他两组(P<0.05)，对照组与水蛭组股静脉血流速度比较差异无统计学意义(P>0.05)。三组患者术后第7天PT、APTT 均要短于术前(P<0.05)，但均处于正常范围之内。结论：低频脉冲联合水蛭能够安全、有效的预防下肢骨折术后深静脉血栓形成。

Clinical Study of Low-Frequency Pulse Therapy combined with Leech in Prevention of Deep Venous Thrombosi after Lower Extremity Fracture Surgery

Objective: To explore the clinical effect of low frequency pulse combined with leech in preventing deep venous thrombosis after lower limb fracture surgery. Methods: Ninety patients with lower limb fracture were randomly divided into three groups, 30 in each group. Control group was treated with Low molecular weight heparin sodium, study groups were treated with low molecular weight heparin sodium + leech and low molecular weight heparin + leech + low frequency pulse resepectively. The coagulation function, hemodynamics, color doppler ultrasound results and the time of detumescence were compared before and after operation. Result: The detumescence time of lower limbs in control group and Hirudo group was 5.2±1.4 and 5.4±1.3 days respectively. The detumescence time of lower limbs in low frequency pulse + Hirudo group was 3.6±0.9 days, which was significantly lower than that in other two groups (P < 0.05). The lower extremity swelling disappeared faster in the low frequency pulse + leech group than in the other two groups (P < 0.05); the blood flow velocity of femoral vein in the low frequency pulse + leech group was faster than other two groups (P < 0.05), and there was no significant difference between the control group and the leech group (P > 0.05). PT and APTT on the 7th day after operation in the three groups were shorter than those before operation (P < 0.05), but they were all under the normal range. Conclusion: The application of Low frequency pulse combined with leech can safely and effectively prevent deep venous thrombosis after lower limb fracture surgery.