冠心病患者骨折后深静脉血栓的发生原因及阿加曲班的干预效果

Causes of deep venous thrombosis after fracture in patients with coronary heart disease and intervention efficiency of argatroban

  • 摘要:
      目的  探讨冠心病患者骨折后深静脉血栓(DVT)发生原因及阿加曲班干预效果。
      方法  选取100例冠心病患者,均为骨折后经B超深静脉探测确诊DVT, 设为研究组。100例未发生DVT患者设为对照组。将研究组患者随机分为A组与B组各50例。A组采取尿激酶治疗, B组采取尿激酶联合阿加曲班治疗。分析冠心病患者骨折后发生DVT的影响因素,比较A组与B组一般资料、临床疗效、治疗前后凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、D-二聚体(D-D)水平及血小板计数(PLT)。
      结果  研究组年龄大于对照组,卧床时间长于对照组, PT、APTT短于对照组,差异均有统计学意义(P < 0.05)。B组总有效率94.00%, 显著高于A组80.00%(P < 0.05)。治疗后A组与B组PT、APTT较治疗前显著延长,且B组显著长于A组(P < 0.05)。治疗后A组与B组D-D、PLT较治疗前显著降低,且B组显著低于A组(P < 0.05)。
      结论  冠心病患者骨折后DVT发生与年龄、卧床时间、PT、APTT等有关,阿加曲班治疗DVT疗效显著,能有效改善患者凝血状态,预防DVT发生。

     

    Abstract:
      Objective  To investigate the causes of deep venous thrombosis (DVT) after fracture in patients with coronary heart disease (CHD) and intervention efficiency of argatroban.
      Methods  A total of 100 patients with CHD were selected as study group, and all of them were diagnosed as DVT after fracture by B type ultrasound examination. Another 100 patients without DVT were selected as control group. The study group was randomly divided into group A and group B, with 50 cases in each group. Group A was treated with urokinase, and group B was treated with urokinase combined with agatroban. Influencing factors of DVT after fracture in patients with CHD were analyzed, and the general data, clinical efficacy, the prothrombin time (PT), activated partial prothrombin time (APTT), D-dimer (D-D) level and platelet count (PLT) before and after treatment were compared between group A and B.
      Results  In the study group, the age of patients was older than the control group, the bed-rest time was longer than the control group, PT and APTT were shorter than the control group, and there were significant differences (P < 0.05). The total effective rate of group B was 94.00%, which was significantly higher than 80.00% of group A (P < 0.05). After treatment, PT and APTT in group A andgroup B were significantly longer than those before treatment, and PT and APTT in group B were significantly longer than group A (P < 0.05). levels of D-D and PLT in group A and group B were significantly lower than those before treatment, and D-D and PLT in group B were significantly lower than group A (P < 0.05).
      Conclusion  The occurrence of DVT after fracture in patients with CHD is related to age, bed-rest time, PT and APTT. Agathorban is effective in the treatment of DVT, which can effectively improve the coagulation state of patients and prevent the occurrence of DVT.

     

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