目的 探究血栓通注射液聯(lián)合利伐沙班治療髖關節(jié)置換術后下肢深靜脈血栓的臨床療效。方法 選取2011年11月—2014年11月在延安大學附屬醫(yī)院骨科接受髖關節(jié)置換術后發(fā)生下肢深靜脈血栓的患者78例,按照治療方案不同分為對照組和治療組,每組各39例。對照組口服利伐沙班片,1片/次,1次/d。治療組在對照組治療的基礎上靜脈滴注血栓通注射液,5 mL溶于0.9%生理鹽水250 mL中,1次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效,比較兩組治療前后D-二聚體、患肢膝上差、膝下差、靜脈血流速度、激活部分凝血活酶時間(APTT)、凝血酶原時間(PT)、凝血酶時間(TT)、纖維蛋白原(FIB)的變化情況。結果 治療后,對照組和治療組的總有效率分別為84.62%、97.44%,兩組比較差異有統(tǒng)計學意義(P<0.05)。治療后,兩組D-二聚體、膝上差、膝下差、FIB均顯著降低,患側血流速度、APTT、PT、TT顯著升高,同組治療前后差異具有統(tǒng)計學意義(P<0.05);且治療組這些觀察指標的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學意義(P<0.05)。結論 血栓通注射液聯(lián)合利伐沙班治療髖關節(jié)置換術后下肢深靜脈血栓具有較好的臨床療效,可顯著改善患者的凝血狀態(tài),具有一定的臨床推廣應用價值。

Objective To explore the clinical effect of Xueshuantong Injection combined with rivaroxaban in treatment of lower limb deep vein thrombus after hip replacement. Methods Patients (78 cases) with lower limb deep vein thrombus after hip replacement in Yan'an University Affiliated Hospital from November 2011 to November 2014 were enrolled in this study. According to the different treatment plan, patients were divided into treatment group (39 cases) and control group (39 cases). The patients in the control group were po administered with Rivaroxaban Tablets, 1 tablet/time, once daily. The patients in the treatment group were iv administered with Xueshuantong Injection on the basis of control group, 5 mL Xueshuantong Injection added into 250 mL 0.9% normal saline, once daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacy were evaluated, and the changes of D-dimer, lower limb diameter difference above and below the knee, venous blood flow velocity, APTT, PT, TT, and FIB in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 84.62% and 97.44%, respectively, and there were differences between two groups (P < 0.05). After treatment, D-dimer, lower limb diameter difference above and below the knee, and FIB in two groups were significantly decreased, venous blood flow velocity, APTT, PT, and TT were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xueshuantong Injection combined with rivaroxaban has clinical curative effect in treatment of lower limb deep vein thrombus after hip replacement, and can significantly improve the blood coagulation state, which has a certain clinical application value.