活血化瘀方对下肢骨折患者术后凝血功能的影响

发布时间：2018-12-11 06:39

【摘要】：目的：通过自拟活血化瘀方联合依诺肝素钠与单纯采用依诺肝素钠对下肢骨折患者术后凝血功能的影响的疗效观察,以此来观察自拟活血化瘀方对下肢骨折患者术后凝血功能的影响。方法：选择2015年3月至2016年3月期间江苏省中医院创伤骨科收诊的遭受下肢骨折(Fracture of lower limb)并且通过彩色多普勒超声检查显示患者双下肢深静脉无血栓形成的患者40例,所有患者随机分成2组,治疗组20例、对照组20例。治疗组在对症治疗的前提下运用自拟活血化瘀方配合依诺肝素钠治疗；对照组单纯采用依诺肝素钠对症治疗以改善患者凝血功能。比较治疗前后两组患者在凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及D一二聚体(D-Dimer)、DVT发生率等指标变化的差异。结果：1.用药后两组患者凝血功能指标比较有统计学意义,治疗组和对照组术后第7天及术后第14天较术后第1天的PT、APTT、FIB、D-二聚体四项凝血指标均有显著改善(P0.01),治疗组术后第14天对D一二聚体(D-Dimer)影响明显优于对照组(P0.01)。2.两组患者在手术治疗后均无深静脉血栓(DVT)形成。3.两组病例患者无胃肠功能不适、过敏等药物不良反应,亦无肠梗阻、肝肾功能异常、压疮、伤口感染等术后并发症。4.相比较而言,治疗组较对照组能更有效改善下肢骨折患者术后创伤引起的患肢疼痛、红肿、肤温较高等症状。结论：活血化瘀方联合依诺肝素钠及单纯使用依诺肝素钠均有显著的抗凝效果,但自拟活血化瘀方联合依诺肝素钠对下肢骨折患者术后凝血功能及血液微循环功能异常的治疗效果,明显优于单纯使用依诺肝素钠组。
[Abstract]:Objective: to observe the effect of self-made Huoxue Huayu recipe combined with enoxaparin sodium and enoxaparin sodium on postoperative coagulation function in patients with lower extremity fracture. To observe the effect of self-made Huoxue Huayu recipe on postoperative coagulation function of patients with lower extremity fracture. Methods: from March 2015 to March 2016, 40 patients with (Fracture of lower limb) of lower extremity fractures who were diagnosed by Department of Orthopedics, Jiangsu Provincial Hospital of traditional Chinese Medicine, and who were diagnosed as having no thrombosis in deep veins of both lower extremities by color Doppler ultrasound, were selected. All patients were randomly divided into two groups: treatment group (n = 20) and control group (n = 20). Under the premise of symptomatic treatment, the treatment group was treated with self-made Huoxue Huayu recipe combined with enoxaparin sodium, while the control group was treated with enoxaparin sodium alone to improve the coagulation function of the patients. The changes of prothrombin time (PT),) activated partial thromboplastin time (APTT),) fibrinogen (FIB) (Fibrinogen (FIB) and D-dimer (D-Dimer), DVT) were compared between the two groups before and after treatment. Results: 1. There was significant difference in coagulation function between the two groups after treatment. The four indexes of PT,APTT,FIB,D- dimer in the treatment group and the control group were significantly improved on the 7th day and the 14th day after operation (P0.01). The effect of D-dimer (D-Dimer) in the treatment group was significantly better than that in the control group on the 14th day after operation (P0.01). There was no deep venous thrombosis (DVT) in both groups after operation. 3. 3%. There were no adverse drug reactions such as gastrointestinal dysfunction, allergy, intestinal obstruction, abnormal liver and kidney function, pressure sore, wound infection and other postoperative complications in the two groups. 4. Compared with the control group, the treatment group was more effective than the control group in improving the symptoms of limb pain, redness and swelling, and high skin temperature caused by postoperative trauma in patients with fracture of lower extremities. Conclusion: Huoxue Huayu recipe combined with enoxaparin sodium and enoxaparin sodium alone has significant anticoagulant effect. But the effect of Huoxue Huayu prescription combined with enoxaparin sodium on coagulation function and blood microcirculation dysfunction in patients with lower extremity fracture after operation was obviously better than that in patients treated with enoxaparin sodium alone.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R274.9

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