Clinical Observation Of Shuxuetong With Low Molecular Weight Heparin In The Treatment Of Post-traumatic Deep Vein Thrombosis

Objective: Deep venous thrombosis is a common complication of orthopedic trauma, it can fall off due to thrombosis caused fatal pulmonary embolism. At present, there are some flaws in the common methods of treatment of deep venous thrombosis, these methods are medication, interventional therapy, surgical treatment, and so on. As the study of the etiology and pathophysiology of DVT deepening, and the new bio-synthetic antithrombotic drugs developing, the methods of treatment are also progressing. Shuxuetong injection, a new antithrombotic drug, is a major concern in recent years, its main ingredients are hirudin and Lumbrukinase. At present, the studies of application Shuxuetong to treat deep venous thrombosis have reported small, here we report a set cases of Shuxuetong with low molecular weight heparin in the treatment of post-traumatic deep vein thrombosis, aimed at evaluating the therapeutic effect and the safety of this method.Methods: According to inclusion criteria and exclusion criteria, we selected 120 cases of post-traumatic deep vein thrombosis treated in our ward from March of 2008 to January of 2010. According to the order of hospital admission, every block includes two patients, these patients who met the selected criterion were randomly distributed in the experiment group and control group. In addition to the general treatment of the two groups, the patients in the experiment group were intravenously infused with Shuxuetong injection 8ml slowly, which were added in 0.9% sodium chloride solution 250mL, once a day, while they were subcutaneously injected with low molecular weight heparin 4100U, two times a day. The patients in the control group were subcutaneously injected with low molecular weight heparin 4100U, two times a day. We observed the following indicatrix before and after treatment:①the degree of limb pain;②the difference of the both lower extremities circumference at the same level (15cm above the knee, and 15cm below the knee);③blood coagulation indicatrix: PT, APTT, FIB, INR;④lower extremity deep venous color Doppler ultrasound. We evaluated the therapeutic effect after the treatment, the standard was:①healing: limb pain disappeared completely, the difference of the both lower extremities circumference at the same level < 0.50cm, color Doppler ultrasound showed complete recanalization or bulk recanalization;②effective: limb pain significantly decreased, the difference of the both lower extremities circumference at the same level < 2.00cm, color Doppler ultrasound showed partly recanalization or venous collateral circulation;③ineffective: there is no decrease of limb pain, the difference of the both lower extremities circumference at the same level > 2.00cm, color Doppler ultrasound showed no vein recanalization. The total effective rate = (number of healing + number of effective)/number of treated cases×100%. All data with the EXCEL Database, and the data was put in SPSS13.0 statistical software for statistical analysis. Measurement data was presented by mean±standard deviation ( x±s), we compared the differences of these data by t-test. Count data was compared by chi-square test. P < 0.05 for the difference was statistically significant.Results: The total effective rate of the experiment group was 98.3% (59/60), the control group was 86.7% (52/60), the difference of the total effective rate between the two groups was statistically significant (P < 0.05), that the therapeutic effect of the experiment group was prior above the control group. The blood coagulation indicatrix in the experiment group before and after treatment was compared, P <0.05, the difference was statistically significant, that there was a change in coagulation status of the patients in the experiment group before and after treatment, APTT and PT extensed, but still within the normal range; INR prolonged, but not more than 1.5 times of the upper limit of normal; FIB reduced, but still within the normal range.Conclusion: It is an effective method to treatment post-traumatic deep vein thrombosis with Shuxuetong injection and low molecular weight heparin. The method is safety, so it needn't to test the tendency of hemorrhage.