摘要
目的比较磺达肝癸钠、那屈肝素钙对骨科大手术后静脉血栓、血栓弹力图(thromboelastography,TEG)参数、预后的影响。方法选取2022年1月—2023年9月收治的120例拟行骨科大手术患者作为研究对象,随机分为对照组和观察组,各60例。对照组采取那屈肝素钙治疗,观察组采取磺达肝癸钠治疗,连续治疗2周。比较2组静脉血栓发生率、不良反应及治疗前后下肢静脉血流速度、TEG参数、预后[简明健康状况量表(medical outcomes study 36-item short-form health survey,SF-36)、Barthel指数(Barthel index,BI)]。结果观察组的血栓事件总发生率低于对照组(0 vs.10.00%,P<0.05);2组治疗2周后的股静脉、腘静脉血流速度比较差异无统计学意义(P>0.05);观察组治疗2周后的MA值、α角分别为(54.42±4.31)mm、(57.62°±5.53°),低于对照组的(59.59±4.66)mm、(60.81°±6.17°),R值、K值分别为(4.82±1.11)min、(2.40±0.61)min,高于对照组的(4.11±0.89)min、(2.08±0.57)min(P<0.05);2组不良反应发生率比较差异无统计学意义(8.33%vs.3.33%,P>0.05);治疗后3个月2组的SF-36、BI评分高于治疗前(P<0.05),但2组比较差异无统计学意义(P>0.05)。结论骨科大手术后使用磺达肝癸钠治疗更有助于预防静脉血栓发生,可改善血液高凝状态,其与那屈肝素钙相比具有一定优势,但两者在生活质量、日常生活能力及安全性方面的作用相似。
Objective To compare and analyze the effects of fondaparinux and nadroparin calcium on venous thrombosis,thromboelastography(TEG)parameters,and prognosis in patients undergoing major orthopedic surgery.Methods A total of 120 patients scheduled for major orthopedic surgery between January 2022 and September 2023 were randomly assigned to a control group and an observation group,60 cases each.The control group received nadroparin calcium,while the observation group received fondaparinux,the treatment was continued for 2 weeks.The incidence of venous thrombosis and adverse reactions were compared between the 2 groups,as well as the changes in lower limb venous blood flow velocity,TEG parameters,and prognosis[medical outcomes study 36-item short-form health survey(SF-36)and Barthel index(BI)]before and after treatment.Results The overall incidence of thrombotic events was lower in the observation group than in the control group(0 vs.10.00%,P<0.05).After 2 weeks of treatment,there was no significant difference in the blood flow velocities of the femoral and popliteal veins between the 2 groups(P>0.05).The observation group had significantly lower MA value and α angles[(54.42±4.31)mm,(57.62°±5.53°)]than the control group[(59.59±4.66)mm,(60.81°±6.17°)],and the R and K values were(4.82±1.11)minutes and(2.40±0.61)minutes,respectively,which were higher than those in the control group,which were(4.11±0.89)minutes and(2.08±0.57)minutes,respectively(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(8.33%vs.3.33%,P>0.05).Three months after treatment,the SF-36 and BI scores of the 2 groups were higher than those before treatment(P<0.05),but there was no significant difference between the 2 groups(P>0.05).Conclusion Fondaparinux is more effective in preventing venous thrombosis after major orthopedic surgery and improves the hypercoagulable state of the blood.Compared with nadroparin calcium,it has certain advantages,but similar effects on quality of life,activities of daily living,and safety.
作者
徐功蒲
李暾
李琼丽
徐伟
XU Gongpu;LI Dun;LI Qiongli;XU Wei(Department of Critical Care Medicine,Shuangliu District People’s Hospital of Chengdu(Airport Hospital of West China Hospital,Sichuan University),Chengdu 610072,China)
出处
《西北药学杂志》
2025年第4期227-232,共6页
Northwest Pharmaceutical Journal
基金
2021年四川省医学会(恒瑞)科研基金专项科研课题(编号:2021HR72)。
关键词
骨科
手术
磺达肝癸钠
那屈肝素钙
静脉血栓
血栓弹力图
预后
orthopedics
surgery
fondaparinux
nadroparin calcium
venous thrombosis
thromboelastography
prognosis
