中西医结合在预防股骨转子间骨折术后深静脉血栓形成中的应用研究

Research on Traditional Chinese and Western Medicine in Prevention of Postoperative Deep Vein Thrombosis of Intertrochanteric Fractures

目的:探究补阳还五汤联合低分子肝素预防股骨转子间骨折术后深静脉血栓形成的临床效果。方法:将医院2011年2月—2014年2月间收治的78例行股骨转子间骨折手术的患者随机平均分为两组,研究组采用补阳还五汤联合低分子肝素钠进行治疗,对照组仅采用低分子肝素钠注射治疗,比较治疗1周后,两组患者术后深静脉血栓发生率与凝血纤溶系统相关指标的差异。结果:术后两天,研究组总引流量达(268.82±12.78)m L,对照组达(345.26±20.83)m L,差异显著(t=19.53,P=0.01<0.05);而经过下肢彩色超声多普勒检查发现,研究组出现3例DTV患者,占整体的5.13%(2/39);对照组出现8例DTV患者,占整体的20.51%(8/39),两组差异具有统计学意义(χ2=4.13,P=0.04<0.05)。而两组患者均无肺栓塞出现,且无其它不良事件。结论:补阳还五汤联合低分子肝素能够有效预防股骨转子间骨折术后深静脉血栓形成,在治疗早期预防效果更佳,值得在临床上进行合理利用。

Objective： To explore the clinical effect of Buyang Huanwu Decoction combined with low molecular heparin to prevent postoperative deep vein thrombosis of intertrochanteric fractures. Methods： In our hospital during February2011 to February 2014,78 patients were randomly divided into two groups. The treatment used to Buyang Huanwu Decoction combined low molecular heparin treatment and the control group was only treated with low molecular heparin sodium injection. One week after treatment,two groups＇ incidence of postoperative deep vein thrombosis and the coagulation fibrinolytic system index were compared. Results： Two days after surgery,the treatment group＇s total drainage volume was（ 268. 82 ± 12. 78） m L and the control group＇s was（ 345. 26 ± 20. 83） m L. There was significant difference（ t = 19. 53,P = 0. 01 0. 05）. And through lower extremity color ultrasonic doppler examination,it found that the treatment group had 3 DTV patients,accounting for 5. 13%（ 2 /39） and the control group had 8 patients with DTV,accounting for20. 51%（ 8 /39）. The differences between the two groups had statistical significance（ χ2= 4. 13,P = 4. 13 0. 05）.The two groups had no pulmonary embolism or other adverse events. Conclusion： Buyang Huanwu Decoction combined with low molecular heparin can effectively prevent postoperative deep vein thrombosis of intertrochanteric fractures. The early prevention effect is better and it is worthy of clinical reasonable use.