活血益气利水方干预老年髋部骨折关节置换术后血液高凝状态的研究
发布时间：2018-07-13 21:42
【摘要】：目的:研究通过对老年髋部骨折术后血液高凝状态的患者早期予以活血益气利水方及低分子肝素钙进行干预观察评价两者联合使用的干预效果,为髋部骨折血液高凝状态患者术后预防血栓形成提供临床依据。方法:从2016年2月至2017年2月入住广西中医药大学第一附属医院骨科行髋部骨折手术(包括股骨颈骨折,股骨粗隆间骨折)的患者;选择符合纳入标准的患者50例,随机分成A、B组,A组为对照组,B组为治疗组,每组患者25例(n=25)。其中A组予低分子肝素钙2500UI,皮下注射,1次/日;B组在A基础上加用活血益气利水方内服,两组同时予常规治疗措施。所有病例观察疗程均为10天;所有病例于术后第1天、第10天观察血浆D-二聚体、纤维蛋白原(FIB)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和血小板计数(PLT)的变化情况,治疗前后还观察患者的患肢周径差值及疼痛评分。对检查结果进行统计学分析,采用SPSSI22统计软件进行统计学处理;组内比较采用配对t检验,组间比较采用独立样本t检验,P0.05为差异具有统计学意义。结果:(1)在观察时间内,两组患者出现症状性下肢DVT中,术后治疗组(B组)DVT的发生0例(0%);对照组(A组)总共发生1例(4%)。实验过程中未出现PTE患者。(2)治疗组、对照组术后第一天与术后第十天两组患者患肢与健侧肢体周径差值及疼痛评分结果比较,差异均有统计学意义(P0.05);且两组患者术后第十天相比,差异均有统计学意义(P0.05)。(3)血液指标方面(D-二聚体、FIB、PT、APTT、PLT):两组患者所有指标术后第一天与术后第十天相比,差异均有统计学意义(P0.05);两组患者所有指标术后第十天相比,差异均有统计学意义(P0.05);两组患者所有指标术后第一天相比,差异均无统计学意义(P0.05)。结论:(1)活血益气利水方能改善髋部骨折术后的血液高凝状态,它能显著降低血液中的Fib、PLT及D-二聚体,延长APTT、PT。(2)活血益气利水方不仅能够降低髋部骨折术后下肢深静脉血栓的发生率,还能减轻患者术后患肢肿胀、疼痛等症状,改善局部血液循环的作用,对老年髋部骨折术后深静脉血栓形成有良好的预防效果。
[Abstract]:Objective: to observe and evaluate the effect of combined use of blood hypercoagulant and low-molecular-weight heparin calcium (LMWHC) on the elderly patients with hip fracture who were treated with Huoxue Yiqi Lishui Fang and low molecular weight heparin calcium in the early stage. To provide clinical basis for prevention of thrombosis after operation in patients with hypercoagulant state of hip fracture. Methods: from February 2016 to February 2017, patients admitted to the Department of Orthopaedics, first affiliated Hospital of Guangxi University of traditional Chinese Medicine, underwent hip fracture surgery (including femoral neck fracture and intertrochanteric fracture), and 50 patients who met the inclusion criteria were selected. Group A was randomly divided into two groups: control group (n = 25), control group (n = 25) and group B (n = 25). Group A was given low molecular weight heparin calcium (LMWH) 2500UI. Group B was given subcutaneous injection of heparin once a day on the basis of A plus internal administration of Huoxue Yiqi Lishui recipe. Both groups were given routine treatment measures at the same time. The changes of plasma D-dimer, fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT) and platelet count (PLT) were observed on the 1st and 10th day after operation. The difference of peripheral diameter and pain score were also observed before and after treatment. Statistical analysis of the results of the test, SPSSI22 statistical software for statistical processing; intra-group comparison using paired t-test, inter-group comparison using independent sample t-test P0.05 as the difference was statistically significant. Results: (1) in the two groups, there were 0 cases (0%) in the treatment group (group B) and 1 case (4%) in the control group (group A). There were no Pte patients in the experiment. (2) in the treatment group and the control group, the difference between the peripheral diameter of the affected and the healthy limbs and the pain score were compared between the first day after operation and the tenth day after operation. The difference was statistically significant (P0.05), and the difference was statistically significant between the two groups on the 10th day after operation (P0.05). (3) (P 0.05). All the indexes of the two groups were compared on the first day after operation and the tenth day after operation. The differences were statistically significant (P0.05); the two groups of all indicators compared with the tenth day after surgery, the differences were statistically significant (P0.05); the two groups of all indicators compared with the first day after surgery, the difference was not statistically significant (P0.05). Conclusion: (1) Huoxue Yiqi Lishui prescription can improve the blood hypercoagulability after hip fracture, and it can significantly reduce the fibrinogen PLT and D-dimer in the blood. (2) Huoxue Yiqi Lishui recipe can not only reduce the incidence of deep venous thrombosis in lower extremities after hip fracture, but also alleviate the symptoms of swelling and pain of the affected limbs, and improve the local blood circulation. It has good preventive effect on deep vein thrombosis after hip fracture in the elderly.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9
[Abstract]:Objective: to observe and evaluate the effect of combined use of blood hypercoagulant and low-molecular-weight heparin calcium (LMWHC) on the elderly patients with hip fracture who were treated with Huoxue Yiqi Lishui Fang and low molecular weight heparin calcium in the early stage. To provide clinical basis for prevention of thrombosis after operation in patients with hypercoagulant state of hip fracture. Methods: from February 2016 to February 2017, patients admitted to the Department of Orthopaedics, first affiliated Hospital of Guangxi University of traditional Chinese Medicine, underwent hip fracture surgery (including femoral neck fracture and intertrochanteric fracture), and 50 patients who met the inclusion criteria were selected. Group A was randomly divided into two groups: control group (n = 25), control group (n = 25) and group B (n = 25). Group A was given low molecular weight heparin calcium (LMWH) 2500UI. Group B was given subcutaneous injection of heparin once a day on the basis of A plus internal administration of Huoxue Yiqi Lishui recipe. Both groups were given routine treatment measures at the same time. The changes of plasma D-dimer, fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT) and platelet count (PLT) were observed on the 1st and 10th day after operation. The difference of peripheral diameter and pain score were also observed before and after treatment. Statistical analysis of the results of the test, SPSSI22 statistical software for statistical processing; intra-group comparison using paired t-test, inter-group comparison using independent sample t-test P0.05 as the difference was statistically significant. Results: (1) in the two groups, there were 0 cases (0%) in the treatment group (group B) and 1 case (4%) in the control group (group A). There were no Pte patients in the experiment. (2) in the treatment group and the control group, the difference between the peripheral diameter of the affected and the healthy limbs and the pain score were compared between the first day after operation and the tenth day after operation. The difference was statistically significant (P0.05), and the difference was statistically significant between the two groups on the 10th day after operation (P0.05). (3) (P 0.05). All the indexes of the two groups were compared on the first day after operation and the tenth day after operation. The differences were statistically significant (P0.05); the two groups of all indicators compared with the tenth day after surgery, the differences were statistically significant (P0.05); the two groups of all indicators compared with the first day after surgery, the difference was not statistically significant (P0.05). Conclusion: (1) Huoxue Yiqi Lishui prescription can improve the blood hypercoagulability after hip fracture, and it can significantly reduce the fibrinogen PLT and D-dimer in the blood. (2) Huoxue Yiqi Lishui recipe can not only reduce the incidence of deep venous thrombosis in lower extremities after hip fracture, but also alleviate the symptoms of swelling and pain of the affected limbs, and improve the local blood circulation. It has good preventive effect on deep vein thrombosis after hip fracture in the elderly.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9
【参考文献】
相关期刊论文 前10条
1 张海龙;王绍辉;李蕊;张宏军;;加味桃红四物汤口服减少全髋关节置换术后低分子肝素钙用量的临床观察[J];风湿病与关节炎;2016年11期
2 黄树勇;郑臣校;李绪松;林小永;;八味伤科活血片对髋部周围骨折后血液高凝状态影响的临床研究[J];广州中医药大学学报;2016年05期
3 陈金雄;余海波;卢绍q，
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