补肾活血法预防肾虚血瘀型下肢骨折术后深静脉血栓形成的临床研究

Clinical Study on Prevention of Postoperative Deep Venous Thrombosis Formation in Kidney Deficiency and Blood Stasis Type of Lower Limb Fracture by Bushenhuoxue Method

目的:观察补肾活血法对肾虚血瘀型下肢骨折术后深静脉血栓(DVT)形成的预防效果。方法:回顾分析本院2013年9月至2016年9月收治需行手术治疗的下肢骨折患者,术后辨证为肾虚血瘀型,共72例。根据是否服用补肾活血汤分为观察组和对照组。观察组与对照组均给予骨科基础治疗,观察组从术后第1天至术后第14天服用补肾活血汤,1剂/d.观察两组术后第1天及第7天大小腿周径差,术后第1天及第14天凝血功能指标和血液流变学指标及两组DVT阳性率。结果:观察组术后第7天的大小腿周径差和术后第14天的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(D-D)、全血黏度高低切,血浆黏度较同期的对照组,差异有统计学意义(P<0.01)。观察组DVT的阳性率2.86%,与阳性率为18.92%的对照组比较,差异有统计学意义(P<0.01)。结论:补肾活血法能改善肾虚血瘀型下肢骨折术后的血栓前状态,有效防止DVT的形成,具有临床应用价值。

Objective：To observe the preventive effect of Bushenhuoxue decoction on the formation of deep venous thrombosis（DVT）in kidney deficiency and blood stasis type of lower limb fractures.Methods：Retrospective analysis a total of72 cases in our hospital from September 2013 to September 2016,which patients underwent the surgery of the lower limb fractures,postoperative syndrome for kidney deficiency and blood stasis type.The patients were divided into the observation group and the control group according to whether taking or not taking the Bushenhuoxue decoction.The observation group and the control group were given orthopedic basic treatment,the observation group was added with Bushenhuoxue decoction for two weeks after surgery.The difference of lower limb perimeter was observed at 1st and 7th day after surgery.The blood coagulation indexes,the hemodynamic indexes and the positive rate of DVT were observed at 1st and14 th day after surgery.Results：Compared with the same period of the control group,there were significant differences in the lower limb perimeter at 7th day after surgery.And at 14 th day after surgery,the activated partial thromboplastin time（APTT）,prothrombin time（PT）,fibrinogen（FIB）,D-dimer（D-D）,the whole blood viscosity at high and low shear and plasma viscosity in the observation group were statistically significantly different（P〈0.01）.The incidence of DVT in the observation group was 2.86%,compared with that in the control group 18.92%,there was statistically significant difference（P〈0.01）.Conclusion：Bushenhuoxue method can improve the post-thrombosis state of the lower limb fractures of the kidney deficiency and blood stasis type,and effectively prevent the formation of DVT,which is valuable for clinical application.