汪祺+付伟标+李云

摘 要 目的：探讨活络骨康丸联合利伐沙班对髋关节置换术后患者的血流动力学指标的影响。方法：采用随机数字表法将69例行髋关节置换术的患者分为观察组（35例）和对照组（34例），观察组用活络骨康丸联合利伐沙班治疗，对照组仅用利伐沙班治疗，比较两组患者血流动力学指标的差异。结果：治疗前，两组患者全血高、低切黏度、血浆比黏度、HCT、EET比较差异无统计学意义（P>0.05），治疗后这些指标明显降低、且观察组明显低于对照组（P<0.05）。2组患者PLT、PT、APTT指标、下肢深静脉血栓发生率及围术期出血量与引流量治疗前后比较的差异无统计学意义（P>0.05）。结论：活络骨康丸联合利伐沙班可显著改善髋关节置换术后患者的血流动力学指标，稍降低下肢深静脉血栓发生风险，且不增加出血风险。

关键词 活络骨康丸 利伐沙班 髋关节置换术 血流动力学

中图分类号：R286； R687.42 文献标识码：B 文章编号：1006-1533（2016）11-0032-04

Effect of Huoluo Gukang pill combined with rivaroxaban on the hemodynamic parameters of the 35 cases of patients with hip replacement surgery*

WANG Qi**， FU Weibiao， LI Yun

（Surgical Department， The People‘s Hospital of Lechang City， Lechang 512200， China）

ABSTRACT Objective： To study the effect of Huoluo Gukang pill combined with rivaroxaban on the hemodynamic parameters of the patients with hip replacement surgery. Methods： Sixty-nine cases of the patients with hip replacement surgery were divided into an observation group （n=35） and a control group （n=34） by the random number table method. The observation group was treated by Huoluo Gukang pill combined with rivaroxaban therapy while the control group only by rivaroxaban therapy. The differences of hemodynamic parameters between the two groups were compared. Results： The comparison of whole blood high and low shear viscosity， plasma specific viscosity， HCT and EET showed no statistical significance （P>0.05） between the two groups before treatment. These indexes were all decreased after treatment and furthermore they were obviously lower in the observation group than the control group （P<0.05）. There was no statistical significance in the PLT， PT and APTT indicators， the incidence of lower extremity deep vein thrombosis and the perioperative blood loss and drainage volume compared before treatment with after （P>0.05）. Conclusion： Huoluo Gukang pill combined with rivaroxaban can slightly reduce the risk of the occurrence of lower extremity deep vein thrombosis by significantly improving hemodynamic parameters without increasing the risk of bleeding.

KEY WORDS Huoluo Gukang pill； rivaroxaban； hip replacement surgery； hemodynamic parameters

利伐沙班是一种高选择性、直接抑制因子Xa的口服药物，可通过剂量途径延长凝血酶原时间（prothrombin time，PT）与活化部分凝血活酶时间（activated partial thromboplastin time，APTT），从而达到抗凝的目的[1]。同时，相关文献显示，活络骨康丸与利伐沙班在治疗激素性股骨头坏死患者中具有重要的预防价值[2]。但关于两种药物联合应用对髋关节置换术后患者的血流动力学指标影响的研究较为罕见，现报道如下。

1 资料与方法

1.1 临床资料

选取我院2012年1月至2015年1月期间外科住院部髋关节置换术后患者69例。纳入标准：全部患者年龄≥18岁，具有髋关节置换术的手术适应证[3]，初次实施髋关节置换术，自愿参加本研究试验并签署知情同意书；排除标准：具有活络骨康丸或利伐沙班过敏史，合并凝血功能障碍性疾病，肝肾功能障碍，抗凝禁忌证，恶性肿瘤，脑卒中，高血压，心肌梗死，冠心病，下肢深静脉血栓，妊娠哺乳期妇女与精神性疾病患者。采……