摘要
目的:研究探讨活血祛瘀中药加非甾体类消炎止痛药诺氯昔康对创伤骨折后高凝状态干预性治疗的有效性及安全性。方法:选择创伤股骨多段闭合骨折后当天入院,年龄18～45岁、ASAⅠ级的患者60例。随机分为3组,各20例。对照组(Ⅰ组),入院后不用任何对凝血功能有影响的药物。中药组(Ⅱ组),入院第2天即给予活血祛瘀中药。中西药组(Ⅲ组),在Ⅱ组基础上加用诺氯昔康。Ⅱ、Ⅲ组用药从入院第2天至第6天。3组患者均在入院第2天、第7天(术日清晨)抽血测定:D D二聚体(D Di)、血小板计数(PLC)、血小板聚集率(PAgR)、凝血弹性描记仪(TEG)的相关指标:R、K、α角、MA。并与健康成年人上述指标进行比较。结果:3组患者骨折后第2天D Di、α角、MA与健康成年人比较P<0.05。3组患者随骨折时间延长至第7天D Di、PAgR、α角、MA均比第1天增大,Ⅰ组增大更明显,PAgR增大的数值(25.49±18.94)与Ⅱ组(9.69±24.89)、Ⅲ组(9.70±14.80)比较有差异(P<0.05)。D Di增加Ⅰ组(277.75±860.25)与Ⅲ组(-189.00±413.68)比较有差异(P<0.05)。α角度增大Ⅰ组(6.17±7.25)与Ⅲ组(1.73±3.78)比较有差异(P<0.05)。结论:患者创伤骨折后凝血功能24h内增强,随时间延长至第7天呈高凝状态,中药、中西结合用药可降低血小板聚集率。
Objective: To investigate the effectiveness and safety of promoting blood flow and removing stasis of traditional Chinese medicine and Lornoxcam(NSAIDs) on hypercoagulability after traumatic femoral fracture.Methods:Sixty patients of femoral fracture were selected with the age 18～45 years and ASA Ⅰ.They were randomly and evenly divided into three groups.In control group (Group Ⅰ) no drugs that affect coagulation were given after their hospitalization.In Chinese medicine group(Group Ⅱ) the patients were given Chinese medicine of promoting blood and removing stasis after their hospitalization until the day before operation(2nd～6th day).In combined Western-Chinese medicine group(Group Ⅲ),the patients were given Lornoxcam and the same Chinese medicine as group Ⅱ from hospitalization to the day before operation.Blood samples were drawn from all patients on the 2nd and 7th day to measure the following indices:D-dimer,platelet count (PLC),platelet agglutination rate(PAgR) and thromboelastograph(TEG).The results were compared with healthy adult volunteers.Results:The 2nd day indices of D-dimer,alpha angle,maximum amplitude(MA) of all patients were significantly different from those of healthy volunteers (P<0.05).The D-dimer,PAgR,alpha angle and MA in the 7th day were significantly increased compared with the 2nd day.The most significant changes were observed in group Ⅰ.Its PAgR(25.49±18.94)were significantly higher than that of group Ⅱ(9.96±24.89,P<0.05) and group Ⅲ(9.70±14.80,P<0.05).D-dimer and alpha angle in group Ⅰ were dramatically increased compared with group Ⅲ(277.75±860.25 vs-189.00±413.68,6.17±7.52 vs 1.73±3.78 respectively,P<0.05).Conclusion:The state of hypercoagulability were observed in patients who were traumatic femoral fracture.Traditional Chinese medicine,especially combined with Western medicine,will decrease the platelet agglutination rate and coagulability,which will be helpful to decrease the probability of deep vein thrombosis after traumatic femoral fracture.
出处
《中国骨伤》
CAS
2005年第5期257-259,共3页
China Journal of Orthopaedics and Traumatology
基金
广东省中医药管理局课题(编号:103144)
