理伤消肿口服液联合低分子肝素预防老年髋部骨折术后DVT的临床研究

发布时间：2017-12-27 14:39

本文关键词：理伤消肿口服液联合低分子肝素预防老年髋部骨折术后DVT的临床研究　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察理伤消肿口服液联合低分子肝素预防老年髋部骨折术后深静脉血栓形成(Deep Vein Thrombosis, DVT)的效果,评价其在预防髋部骨折术后DVT的应用价值,为临床应用中医中药预防髋部骨折术后DVT提供借鉴和参考。方法：根据纳入标准,选取2015年8月至2016年2月广州中医药大学第一附属医院创伤骨科老年髋部骨折(股骨颈骨折或股骨转子间骨折)行手术治疗的患者共52例,随机分成试验组和对照组,每组各26例。在常规治疗的基础上,试验组术后予理伤消肿口服液联合低分子肝素进行抗凝治疗,对照组则单独应用低分子肝素治疗,观察两组患者术后第1天和术后第7天血浆D-二聚体、血浆同型半胱氨酸(Hcy)、C-反应蛋白(CRP)、纤维蛋白原(Fib)等指标及患肢大腿周径的变化,并于术后第7天行双下肢静脉彩超检查统计两组患者DVT的发生率。所有数据均采用Stata/SE11.0统计软件进行分析,P0.05,认为差异有统计学意义。结果：对两组患者的基本资料(性别、年龄、骨折部位)进行比较,组间差异无统计学意义。两组患者术后第1天患肢肿胀程度、血浆D-二聚体、CRp、Fib、Hcy比较,组间差异无统计学意义。两组患者共有5例发生DVT,总发生率为9.62%。试验组中有2例发生DVT,发生率为7.69%;对照组中有3例发生DVT,发生率为11.54%,组间差异无统计学意义(P=0.64)。两组患者术后第7天患肢肿胀程度(P=0.002)、D-二聚体(P=0.0198)、CRP (P=0. 011)、Fib (P=0.036)对比,差异均具有统计学意义；对比两组患者术后第7天血浆Hcy的水平,差异无统计学意义(P=0.15)。结论：理伤消肿口服液联合低分子肝素可有效预防老年髋部骨折患者术后下肢深静脉血栓形成的发生,其疗效与单独应用低分子肝素相当。但联合应用在改善血液高凝状态、减轻术后炎症反应及消除患肢肿胀方面具有一定的优势,值得临床推广应用。
[Abstract]:Objective: To observe the effect of Lishang Xiaozhong oral liquid combined with low molecular heparin in the prevention of hip fracture in elderly patients with deep venous thrombosis (Deep Vein, Thrombosis, DVT) effect, and evaluate its application value in the prevention of postoperative DVT hip fracture, hip fracture after DVT and provide the reference for the clinical application of traditional Chinese medicine. Methods: according to the inclusion criteria, from August 2015 to February 2016 in Guangzhou University of Chinese Medicine First Affiliated Hospital Department of orthopedics trauma hip fracture (femoral neck fractures or femoral intertrochanteric fracture) of the surgical treatment of patients with a total of 52 cases were randomly divided into experimental group and control group, 26 cases in each group. On the basis of routine treatment, experimental group were treated by Lishang Xiaozhong oral liquid combined with low molecular weight heparin anticoagulant therapy, the control group only treated with low molecular weight heparin, day surgery and observe two groups of patients after first and seventh days after the plasma D- two dimer, plasma homocysteine (Hcy) and C- reaction protein (CRP), fibrinogen (Fib) and other indicators of limb circumference changes, and on the seventh postoperative day double venous ultrasonography statistics of two groups of patients the incidence of DVT. All data were analyzed with Stata/SE11.0 statistical software, P0.05, and the difference was statistically significant. Results: the basic data (sex, age, fracture site) of the two groups were compared, and there was no significant difference between the groups. The degree of limb swelling, plasma D- two polymer, CRp, Fib and Hcy were compared between the two groups at first days after operation, and there was no significant difference between the groups. A total of 5 patients in the two group had DVT, with a total incidence of 9.62%. In the experimental group, there were 2 cases of DVT, the incidence of which was 7.69%, and 3 cases in the control group were DVT, and the incidence was 11.54%. There was no significant difference between the groups (P=0.64). Two groups of patients seventh days after operation, limb swelling degree (P=0.002), D- two mer (P=0.0198), CRP (P=0. 011), Fib (P=0.036) contrast, the difference was statistically significant, compared two groups of patients seventh days after operation, plasma Hcy level, the difference was not statistically significant (P=0.15). Conclusion: the rational injury and detumescence oral liquid combined with low molecular weight heparin can effectively prevent the occurrence of postoperative deep venous thrombosis in elderly patients with hip fracture, and its curative effect is comparable to the application of low molecular weight heparin alone. However, it has some advantages in improving the state of hypercoagulable blood, alleviating the postoperative inflammatory response and eliminating the swelling of the affected limbs. It is worthy of clinical application.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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