益气活血通络汤联合低分子肝素钙减少股骨转子间骨折术后下肢深静脉血栓的临床观察

发布时间：2018-04-23 08:57

本文选题：益气活血通络汤 + 股骨转子间骨折　；参考：《湖南中医药大学》2015年硕士论文

【摘要】：目的：观察自拟益气活血通络汤联合低分子肝素钙减少老年股骨转子间骨折术后下肢深静脉血栓形成(DVT)的临床疗效,减轻术后并发症,分析益气活血通络汤联合低分子肝素钙的临床安全性,为临床中进一步推广提供理论依据。方法：将纳入研究的80例老年股骨转子间骨折患者采用随机分组方法,分为对照组和治疗组。对照组：于术后12-24小时皮下给予常规剂量(4100u)低分子肝素钙；皮下注射。每日一次,术后第1天至第14天。试验组：益气活血通络汤煎服,一日2次,一次200m1。于术后第一天到第十四天服用；低分子肝素钙于术后12-24小时给予常规剂量(4100u)皮下注射。每日一次,术后第1天至第14天。两组患者入院时行常规检查,所有患者围手术期采用统一的治疗措施。统计术后引流量,凝血五项及双下肢动静脉彩超检查等,观察是否有DVT发生。所得数据均采用SPSS19.0统计软件进行分析。结果：试验组在术后患肢疼痛、肿胀和瘀斑面积方面优于对照组,差异有统计学意义；试验组的术后引流量少于对照组,差异有统计学意义；试验组在凝血五项方面优于对照组,差异有统计学意义。根据下肢深静脉形成的诊断标准,术后两组共出现9例DVT患者,发生率为23.4%,血栓均发生在患侧肢体。其中对照组7例,发生率为18.4%,试验组2例,发生率为5%。经统计学分析,试验组在血栓发生率方面优于对照组,差异有统计学意义。所有病例中未出现肺栓塞(PTE)及死亡病例。所有患者入院时与术后肝肾功能等检查结果经统计学分析,无明显差异,所有患者无不良反应发生。结论：自拟益气活血通络汤联合低分子肝素钙能明显降低下肢深静脉血栓的发生率,具有明显的抗凝作用.效果优于单纯应用低分子肝素钙；益气活血通络汤联合低分子肝素钙能减少患肢疼痛、肿胀和瘀斑面积和术后引流量,减轻了术后一系列并发症；两组患者均未发生全身和局部的不良发应,益气活血通络汤联合低分子肝素是较为安全的临床药物。
[Abstract]:Objective: to observe the clinical effect of self-made decoction of supplementing qi and activating blood circulation and Tongluo decoction combined with low molecular weight heparin calcium in reducing DVT of lower extremity deep vein thrombosis after operation of intertrochanteric fracture of femur in elderly patients, and to reduce postoperative complications. The clinical safety of Yiqi Huoxue Tongluo decoction combined with low molecular weight heparin calcium was analyzed. Methods: 80 elderly patients with intertrochanteric fracture of femur were randomly divided into control group and treatment group. Control group: 12-24 hours after operation subcutaneous administration of conventional dose of 4 100 u) low molecular weight heparin calcium; subcutaneous injection. Once a day, 1 to 14 days after operation. Test group: Yiqi Huoxue Tongluo decoction decoction, 2 times a day, 200 ml. Low molecular weight heparin calcium was injected subcutaneously from the first day to the fourteenth day after operation. Once a day, 1 to 14 days after operation. Routine examination was performed on admission in both groups, and all patients were treated with uniform treatment during perioperative period. Postoperative drainage, coagulation and lower extremity arteriovenous ultrasonography were analyzed to determine whether DVT occurred. The data were analyzed by SPSS19.0 software. Results: the experimental group was superior to the control group in the area of pain, swelling and ecchymosis of the affected limbs after operation, the difference was statistically significant, and the postoperative drainage volume in the test group was less than that in the control group, and the difference was statistically significant. The test group was superior to the control group in five aspects of coagulation, the difference was statistically significant. According to the diagnostic criteria of deep vein formation in the lower extremity, 9 cases of DVT were found in the two groups after operation, the incidence rate was 23.4%, and the thrombus occurred in the affected limbs. There were 7 cases in the control group (18. 4%) and 2 cases in the experimental group (5 cases). By statistical analysis, the experimental group was superior to the control group in the incidence of thrombus, the difference was statistically significant. There were no PTEs and death in all cases. There was no significant difference in the results of liver and kidney function between the patients after admission and after operation, and no adverse reactions occurred in all patients. Conclusion: combined with low molecular weight heparin calcium can obviously reduce the incidence of deep vein thrombosis of lower extremity and has obvious anticoagulant effect. The effect was better than that of using low molecular weight heparin calcium alone, Yiqi Huoxue Tongluo decoction combined with low molecular weight heparin calcium could reduce the pain, swelling, ecchymosis area and drainage flow of the affected limbs, and lighten a series of complications after operation. There was no systemic or local adverse reaction in both groups. Yiqi Huoxue Tongluo decoction combined with low molecular weight heparin was a safe clinical drug.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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