摘要
目的探讨红元胶囊联合利伐沙班对预防老年髋部骨折术后静脉血栓栓塞的疗效。方法选取2017年9月至2019年9月住院的老年髋部骨折患者172例,采用前瞻性随机对照试验方法,红元胶囊联合利伐沙班组与利伐沙班组按照1∶1分配。采用前瞻性随机对照研究并在术后随访6个月。结果2组患者在年龄、性别比、BMI、麻醉方式、住院到手术时间上差异均无统计学意义(P>0.05)。随访至术后6个月,术后每个月回院复查下肢血管彩超、胸部CT。2组术后DVT、PE发生率差异无统计学意义(P>0.05)。2组在临床相关出血中差异并无统计学意义(P=0.755)。2组术后引流量差异无统计学意义(P=0.884)。2组术后血肿病例数差异无统计学意义(P=0.700)。术前3 d 2组PLT、PT差异并无统计学意义(P=0.699,P=0.097),红原胶囊联合利伐沙班组APTT较利伐沙班组时间明显缩短,差异有统计学意义(P=0.020)。术后7 d红原胶囊联合利伐沙班组PLT较利伐沙班组增多,差异有统计学意义(P=0.038)。术后7 d红原胶囊联合利伐沙班组APTT、PT均较利伐沙班组缩短,差异有统计学意义(P=0.005,P=0.013)。结论红元胶囊联合利伐沙班治疗的患者较单纯应用利伐沙班治疗的患者,术后DVT、PE发生率并无明显差异。但通过术前与术后检测患者凝血功能与血小板数量,发现红原胶囊联合利伐沙班可以使患者凝血维持在更加相对平稳的水平,可减少患者术后出血事件或伤口血肿的发生,引流管引流量也可相对减少。
Objective To investigate the effects of Hongyuan capsule combined with rivaroxaban in preventing the occurrence of venous thromboembolism in elderly patients with hip fracture after operation.Methods A total of 172 elderly patients with hip fracture who were treated in our hospital from September 2017 to September 2019 were enrolled in the study.The prospective randomized controlled trial was adopted,and the patients were randomly divided into rivaroxaban group and combination treatment group(Hongyuan capsule combined with rivaroxaban),with 86 cases in each group.The patients in both groups were followed up for 6 months to observe the therapeutic effects.Results There were no significant differences in patient’s age and gender,BMI,anesthesia modality,and the time from hospitalization to surgery between the two groups(P>0.05).After 6-month follow up,there were no significant differences in lower limb vascular ultrasound and chest CT examination results as well as the incidence rates of DVT and PE between the two groups(P>0.05).Moreover there were no significant differences in clinically relevant bleeding,postoperative drainage volume,and the number of postoperative hematoma cases as well as the levels of PLT and PT at 3d before operation between the two groups(P>0.05).However the APTT time in combination treatment group was significantly shorter than that in rivaroxaban group(P<0.05),and the PLT levels at 7 days after operation in combination treatment group were significantly higher than those in rivaroxaban group(P<0.05).In addition the APTT and PT at 7 days after operation in combination treatment group were significantly shorter than those in rivaroxaban group(P<0.05).Conclusion The therapeutic effects of Hongyuan capsule combined with rivaroxaban are superior to those by simple rivaroxaban in treatment of hip fracture in elderly patients,the former can maintain stable coagulation levels,reduce the incidence of postoperative bleeding events and wound hematoma,and reduce the drainage tube drainage volume.
作者
邢宝瑞
冯娜娜
张娟
李运美
侯秀秀
吴昊
刘文东
韩广普
XING Baorui;FENG Nana;ZHANG Juan(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei,Cangzhou 061000,China)
出处
《河北医药》
CAS
2021年第24期3769-3772,共4页
Hebei Medical Journal
基金
河北省中医药管理局中医药类科技计划项目(编号:3602240)。
关键词
红原胶囊
利伐沙班
髋部
骨折
老年人
血栓
随机对照
Hongyuan capsule
hip
rivaroxaban
fracture
the elderly
thrombus
randomized controlled trial
