新癀片联合低分子肝素钠预防髋部周围骨折后深静脉血栓形成的临床研究
发布时间：2018-12-16 07:04
【摘要】：目的：通过观察新癀片联合低分子肝素钠预防髋部周围骨折后深静脉血栓形成的临床疗效,为中医药预防下肢深静脉血栓临床研究积累经验。方法：自2013年12月至2014年12月175医院骨科医院选择符合纳入标准及排除标准的病例74例,按照入院时间的先后顺序随机数字法分为治疗组(n=37)和对照组(n=37)。对照组予低分子肝素钠注射,100 IU/kg,皮下注射,每日一次；治疗组在对照组基础上予口服新癀片(0.64g/次,2次／天)。记SPSS录术中出血量、术后总引流量；分别于入院当天及术后第3、7、12天抽血行凝血功能、D-二聚体及血小板测定,术前术后下肢深静脉彩超检查。并测量两组患者患肢周径、疼痛缓解情况,并记录数据。所得数据用17.0统计学软件进行分析,设定P0.05具有统计学意义。结果：1、本研究中治疗组有3例患者出现血栓,在入院当天、术后第3天分别发现1例、2例,出现在股静脉1例,胭静脉2例,对照组有11例,在入院当天、术后第3、7天分别发现3例、4例、4例,出现在股静脉6例,胭静脉5例,血栓发生率分别为8.11%、29.73%,两组血栓发生率差异有统计学意义(P0.05)。2、两组患者入院当天的PT、APTT、FIB.D-二聚体含量差异无统计学意义(P0.05)。术后第3、7、12天差异有统计学意义(P0.05)。两组患者INR值差异无统计学意义(P0.05)。3、两组患者入院当天及术后12天血小板计数差异无统计学意义(P0.05)；术后第3、7天两组患者的血小板计数差异有统计学意义(P0.05)。4、两组患者术中出血量及术后48小时引流量比较差异无统计学意义(P0.05)。5、术后3、7、12天,两组患者的大腿周径差及疼痛VAS评分比较差异有统计学意义(P0.05)。结论：新癀片联合低分子肝素钠能缓解局部肿胀和疼痛,改善血液高凝状态、改善血液纤溶活性,对髋部周围骨折术后深静脉血栓形成有良好的预防效果,其疗效优于低分子肝素钠组。在术前开始应用新癀片预防血栓,并未增加出血的风险,体现用药的安全性,表明可以在髋部周围骨折后即开始早期应用中药预防深静脉血栓。今后可通过动物实验,进一步研究其预防血栓的作用机制。
[Abstract]:Objective: to observe the clinical effect of Xinhuang tablet combined with low molecular weight heparin sodium (LMWH) on the prevention of deep venous thrombosis (DVT) after perihip fracture, and to accumulate experience in the clinical study of prevention of deep venous thrombosis (DVT) in lower extremity by traditional Chinese medicine. Methods: from December 2013 to December 2014, 74 patients in orthopedic hospital of 175 hospitals were randomly divided into treatment group (n = 37) and control group (n = 37) according to the order of admission time. The control group was given low-molecular-weight heparin sodium injection, 100 IU/kg, subcutaneously once a day, and the treatment group was given 0.64g/ tablet (twice a day) on the basis of the control group. The blood coagulation function, D-dimer and platelet were measured on the day of admission and on the 7th day after operation, and the deep veins of lower extremities were examined by color Doppler ultrasonography before and after operation. The circumference of the affected limbs and pain relief were measured, and the data were recorded. The data were analyzed by 17.0 statistical software, set P0.05 has statistical significance. Results: 1Thrombosis was found in 3 patients in this study group. On the day of admission, 1 case, 2 cases were found in femoral vein, 2 cases in popliteal vein, 11 cases in control group, on the day of admission, 2 cases were found in the femoral vein, 2 cases in the popliteal vein, and 11 cases in the control group on the day of admission. On the 3rd day after operation, 3 cases, 4 cases appeared in femoral vein and 5 cases in popliteal vein, respectively. The incidence of thrombus was 8.11 and 29.73, respectively. The difference between the two groups was statistically significant (P0.05). There was no significant difference in PT,APTT,FIB.D- dimer content between the two groups on admission day (P0.05). There was significant difference on the 3rd day after operation (P0.05). There was no significant difference in INR between the two groups (P0.05). There was no significant difference in platelet count between the two groups on the day of admission and 12 days after operation (P0.05). There was significant difference in platelet count between the two groups on the 3rd and 7th day after operation (P0.05). 4. There was no significant difference between the two groups in intraoperative blood loss and 48 hours of drainage (P0.05), 3 days after operation (P0.05), 712 days after operation. There were significant differences in thigh circumference difference and pain VAS score between the two groups (P0.05). Conclusion: Xinhuang tablet combined with low molecular weight heparin sodium can relieve local swelling and pain, improve blood hypercoagulability, improve blood fibrinolytic activity and prevent deep vein thrombosis after hip fracture. The therapeutic effect was better than that of low molecular weight heparin sodium group. The application of Xinhuang tablet to prevent thrombosis before operation did not increase the risk of bleeding. It showed the safety of medication. It indicated that Chinese medicine could be used to prevent deep venous thrombosis early after fracture of hip. The mechanism of prevention of thrombus can be further studied by animal experiments in the future.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
本文编号：2381964
[Abstract]:Objective: to observe the clinical effect of Xinhuang tablet combined with low molecular weight heparin sodium (LMWH) on the prevention of deep venous thrombosis (DVT) after perihip fracture, and to accumulate experience in the clinical study of prevention of deep venous thrombosis (DVT) in lower extremity by traditional Chinese medicine. Methods: from December 2013 to December 2014, 74 patients in orthopedic hospital of 175 hospitals were randomly divided into treatment group (n = 37) and control group (n = 37) according to the order of admission time. The control group was given low-molecular-weight heparin sodium injection, 100 IU/kg, subcutaneously once a day, and the treatment group was given 0.64g/ tablet (twice a day) on the basis of the control group. The blood coagulation function, D-dimer and platelet were measured on the day of admission and on the 7th day after operation, and the deep veins of lower extremities were examined by color Doppler ultrasonography before and after operation. The circumference of the affected limbs and pain relief were measured, and the data were recorded. The data were analyzed by 17.0 statistical software, set P0.05 has statistical significance. Results: 1Thrombosis was found in 3 patients in this study group. On the day of admission, 1 case, 2 cases were found in femoral vein, 2 cases in popliteal vein, 11 cases in control group, on the day of admission, 2 cases were found in the femoral vein, 2 cases in the popliteal vein, and 11 cases in the control group on the day of admission. On the 3rd day after operation, 3 cases, 4 cases appeared in femoral vein and 5 cases in popliteal vein, respectively. The incidence of thrombus was 8.11 and 29.73, respectively. The difference between the two groups was statistically significant (P0.05). There was no significant difference in PT,APTT,FIB.D- dimer content between the two groups on admission day (P0.05). There was significant difference on the 3rd day after operation (P0.05). There was no significant difference in INR between the two groups (P0.05). There was no significant difference in platelet count between the two groups on the day of admission and 12 days after operation (P0.05). There was significant difference in platelet count between the two groups on the 3rd and 7th day after operation (P0.05). 4. There was no significant difference between the two groups in intraoperative blood loss and 48 hours of drainage (P0.05), 3 days after operation (P0.05), 712 days after operation. There were significant differences in thigh circumference difference and pain VAS score between the two groups (P0.05). Conclusion: Xinhuang tablet combined with low molecular weight heparin sodium can relieve local swelling and pain, improve blood hypercoagulability, improve blood fibrinolytic activity and prevent deep vein thrombosis after hip fracture. The therapeutic effect was better than that of low molecular weight heparin sodium group. The application of Xinhuang tablet to prevent thrombosis before operation did not increase the risk of bleeding. It showed the safety of medication. It indicated that Chinese medicine could be used to prevent deep venous thrombosis early after fracture of hip. The mechanism of prevention of thrombus can be further studied by animal experiments in the future.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3
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