通脉汤对下肢闭合骨折深静脉血栓的影响及其血栓弹力图的变化

Effect of Tong Mai Decoction on Deep Vein Thrombosis of Lower Limb Fracture and Changes in Its Elastic Force Diagram

目的：探讨下肢闭合骨折深静脉血栓患者使用通脉汤后,其病情预后的发展及血栓弹力图的变化,并进行分析。方法：于2014年1月至2015年12月,随机选择我院因下肢闭合骨折行切开复位内固定术前经各项检查证实存在高凝状态的住院患者68例,其中女21例,男47例;年龄20-70岁,平均年龄（51.42±6.06）岁;将患者随机分为治疗组、对照组,每组各34例,2组均进行常规切开复位内固定及骨科基础治疗,同时对照组予1 000 u低分子肝素及抗血小板活性药物治疗,治疗组加以口服汤剂通脉汤。分别于术前、术后第7 d、第14 d测定血浆凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）/血小板计数及血栓弹力图（Thrombelastograph,TEG）变化。结果：在术后进行干预治疗后,2组患者在术后第14 d的PT、APTT及血栓弹力图检测与术前相比均有明显改善（P〈0.05）,但在各项指标的组间比较中,治疗组与对照组差异无统计学意义（P〉0.05）。结论：通脉汤能有效改善患者血液高凝状态,是一种治疗深静脉血栓的有效手段。

Objective：To investigate the development of the prognosis of patients with deep venous thrombosis after closed fracture of lower limb and the change of the blood clot elastic diagram.Methods：Lower limb closed fractures 68 cases during January 2014 to December 2015 in our hospital were selected randomly.And they were treated by open reduction and internal fixation and confirmed to be in hypercoagulable state,including 21 cases of female,47 male,aged 20 -70,mean age （51.42 ±6.06）.They were randomly divided into treatment group and control group,34 cases in each group,two groups were given conventional open reduction and internal fixation and orthopaedic basic treatment,while the control group was treated with 1 000u low molecular heparin and antiplatelet activity drug treatment,the treatment group were given oral Tongmai Decoction.Plasma prothrombin time （PT）,activated partial prothrombin time （APTT）,platelet count and thrombelastograph （TEG）were measured before the treatment and after 7th days and 14th days＇treatment respectively.Results：After the intervention,the 7 d and 14 d PT,APTT and TEG were improved significantly in both two groups（P 〈0.05）,no significant differences were found between the two groups （P〉0.05）.Conclusion：Tongmai Decoction can effectively improve the blood coagulation state,which is an effective treatment of deep venous thrombosis.