补阳还五汤联合CPM机治疗股骨远端骨折术后DVT形成临床观察

Clinical Analysis of Buyang Huanwu Decoction Combined with CPM Machine in the Treatment of DVT after Distal Femoral Fractures

目的:探讨补阳还五汤联合CPM机对于股骨远端骨折术后凝血指标的影响,分析其预防下肢深静脉血栓(DVT)的疗效。方法:选取股骨远端骨折手术后患者120例,按随机数字表法平分为两组,各60例。分析两组术前、术后2d、7d、14d血流动力学指标、D2聚体水平变化及术后各时段患肢肿胀和膝关节功能评分。结果:两组术前、术后2d各血液学指标、患肢肿胀、膝关节HSS评分比较,差异无统计学意义(P>0.05),治疗7d后两组除PT变化无统计学差异外(P>0.05),其余各指标均有统计学差异(P<0.05)。术后14d两组各凝血指标及膝关节HSS评分均较治疗前有所改善,且中药组能延长APTT,有效降低D2聚体、FIB,减轻患肢肿胀程度,两组相比均有统计学差异(P<0.05),且中药组膝关节HSS评分优于对照组,表明补阳还五汤联合CPM机可有效改善术后血液高凝状态及膝关节功能。结论:补阳还五汤联合CPM机可明显改善术后血液高凝状态及膝关节功能,减轻患肢肿胀,预防DVT的发生。

Objective:To investigate the effect of Buyang Huanwu Decoction combined with CPM machine on the coagulation parameters of distal femoral fractures,and to analyze the curative effect of preventing deep vein thrombosis(DVT)in the lower extremities.Methods:A total of 120 patients with distal femoral fractures were selected and divided into two groups of 60 cases according to the random number table method.The hemodynamic indexes and D2 polymer levels of the two groups were analyzed before and after 2 d,7 d,and 14 d.Swelling of the affected limb and knee joint function scores at various periods after surgery.Results:There were no significant differences in hematological parameters,swelling of the affected limb,and HSS score of the knee joint between the two groups before and 2 days after surgery(P>0.05).There was no difference in PT between the two groups after 7 days of treatment(P>0.05),Except for other indicators(P<0.05).At 14 days after operation,the blood coagulation parameters and HSS scores of the knee joints in the two groups were improved compared with those before treatment,and the Chinese medicine group could prolong APTT,effectively reduce D2 aggregates,FIB,and reduce the degree of swelling of the affected limbs(P<0.05).The HSS score of the knee joint in the traditional Chinese medicine group was better than that in the control group,indicating that Buyang Huanwu Decoction combined with CPM machine can effectively improve the blood hypercoagulability and knee joint function after operation.Conclusion:Buyang Huanwu decoction combined with CPM machine can significantly improve the blood coagulation state and knee joint function,reduce swelling of the affected limb,and prevent the occurrence of DVT.