摘要
【目的】探讨补阳还五汤联合低分子肝素预防股骨转子间骨折术后深静脉血栓形成(DVT)的临床疗效。【方法】根据性别、年龄、手术时间、手术方式及Evens分型将96例股骨转子间骨折术后病例按照分层随机化法分为试验组和对照组各48例。2组均给予皮下注射低分子肝素,同时试验组给予补阳还五汤治疗,每日1剂,连续7 d。分别观察2组受试对象试验前、试验后凝血—纤溶系统、血液流变学指标及伤肢彩色多普勒超声检查结果的变化情况。【结果】(1)试验后,2组患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)与D-二聚体(D-D)、组织型纤溶酶原激活抑制因子(PAI)等凝血—纤溶系统相关指标及血液流变学指标均显著改善,与试验前比较,差异均有统计学意义(P<0.05),且试验组的改善作用优于对照组,差异均有统计学意义(P<0.05)。(2)伤肢彩色多普勒超声检查结果显示,试验组的伤肢DVT发生率明显少于对照组,2组比较差异有统计学意义(P<0.05)。【结论】补阳还五汤联合低分子肝素能够改善股骨转子间骨折术后患者血液高凝状态,激活纤溶系统,调节血液流变学状态,预防伤肢深静脉血栓形成。
Objective To explore the preventive effect of Buyang Huanwu decoction combined with low molecular weight heparin on deep vein thrombosis （DVT） in femoral intertrochanteric fracture patients after surgery. Methods The prospective, randomized, controlled clinical trial design was adopted. According to the gender, age, operative time, surgical approach and Evens＇ classification, 96 cases were evenly divided into experimental group and control group in accordance with the method of stratified randomization at proportion of 1：1. By following China Major Orthopedic Surgery Venous Thromboembolism Prevention Guideline, both groups were treated with subcutaneous injection of low molecular weight heparin. Simultaneously, the experimental group was treated with oral use of Buyang Huanwu decoction, one dose a day for 7 continuous days. Before and after treatment, coagulation-fibrinolysis system and hemorheology indices of prothrombin time （FF） , activated partial thromboplastin time （APTY）, D-dimer （D-D） and tissue-type plasminogen activator inhibitor （PAI） , and color Doppler uhrasonograms of the injured limb deep veins were observed in both groups. Results （1） After treatment, coagulation-fibrinolysis system and hemorheology indices of PT, APTT, D-D and PAI were improved in both groups （P〈0.05 compared with those before treatment）, and the improvement in the treatment group was superior to that in the control group （P〈0.05） . （2） The results of color Doppler ultrasonography for the injured limb deep veins showed that the incidence of DVT in the injured limb was less in the treatment group than that in the control group, and the difference was significant （P〈 0.05）. Conclusion Buyang Huanwu decoction combined with low molecular weight heparin has preventive effect on injured limb deep vein thrombosis in patients with femoral intertrochanteric fracture after surgery , and the mechanism is related with improving the blood bypercoagulabale state, activating coagulation-fibrinol
出处
《广州中医药大学学报》
CAS
北大核心
2014年第1期1-6,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
国家临床重点专科建设项目(中医专业)
广东省中医药局科研项目(编号:20111064)
关键词
补阳还五汤
低分子肝素
股骨转子间骨折
深静脉血栓形成
Buyang Huanwu decoction
Low molecular weight heparin
Femoral intertrochanteric fracture
Deep vein thrombosis
