目的 探究血栓通注射液联合利伐沙班治疗髋关节置换术后下肢深静脉血栓的临床疗效。方法 选取2011年11月—2014年11月在延安大学附属医院骨科接受髋关节置换术后发生下肢深静脉血栓的患者78例,按照治疗方案不同分为对照组和治疗组,每组各39例。对照组口服利伐沙班片,1片/次,1次/d。治疗组在对照组治疗的基础上静脉滴注血栓通注射液,5 mL溶于0.9%生理盐水250 mL中,1次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组治疗前后D-二聚体、患肢膝上差、膝下差、静脉血流速度、激活部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为84.62%、97.44%,两组比较差异有统计学意义(P<0.05)。治疗后,两组D-二聚体、膝上差、膝下差、FIB均显著降低,患侧血流速度、APTT、PT、TT显著升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 血栓通注射液联合利伐沙班治疗髋关节置换术后下肢深静脉血栓具有较好的临床疗效,可显著改善患者的凝血状态,具有一定的临床推广应用价值。

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.