田七口服液联合低分子肝素预防股骨粗隆骨折下肢深静脉血栓发生的临床研究

Clinical study of Tianqi Oral Liquid combined with low-molecular-weight heparin in the prevention of the occurrence of lower extremity deep venous thrombosis in patients with femoral intertrochanteric fractures

目的观察田七口服液联合低分子肝素预防股骨粗隆骨折下肢深静脉血栓发生的临床研究分析。方法选取2018年2月1日至2021年1月31日广东省中山市中医院骨二科就诊并确定以股骨粗隆骨折为诊断收治的患者100例,根据随机数字表法分组,每组各50例,其中50例患者予以常规皮下注射低分子肝素抗凝的预防性治疗为对照组,另50例患者则予以常规皮下注射低分子肝素抗凝联合口服本院自制剂田七口服液为治疗组。比较两组患者接受预防性治疗前、后的凝血相关指标、下肢超声血流动力学指标与下肢疼痛评分,统计患者在接受预防性治疗后的下肢肿胀、深静脉血栓、肺栓塞形成率,并对患者在住院期间发生的其他并发症进行比较。结果预防性治疗后,两组患者D-D、凝血四项各指标及血小板水平明显改变,其中D-D、PT、APTT、TT及血小板水平较预防性治疗前下降,治疗组低于对照组,Fbg水平则较治疗前升高,治疗组高于对照组,差异有统计学意义(P<0.05)。两组患者下肢超声血流动力学指标与下肢疼痛评分水平明显改变,其中下肢超声血流动力学指标较预防性治疗前升高,治疗组高于对照组,下肢疼痛评分较预防性治疗前下降,治疗组低于对照组,差异有统计学意义(P<0.05)。治疗组患者预防性治疗后,下肢肿胀、深静脉血栓发生率均明显低于对照组,差异有统计学意义(P<0.05);治疗组肺栓塞形成率稍低于对照组,但差异无统计学意义(P>0.05)。治疗组患者在住院期间其他的并发症总发生率稍低于对照组,但差异无统计学意义(P>0.05)。结论在IFF患者中,以田七口服液联合低分子肝素进行预防性治疗,可以较为明显地改善患者的凝血指标,提升下肢的血流速度,减少下肢肿胀及疼痛,减少下肢深静脉血栓的发生。

Objective To observe the clinical study and analysis of Tianqi oral liquid combined with lowmolecular-weight heparin(LMWH)to prevent the occurrence of lower extremity deep venous thrombosis in patients with femoral intertrochanteric fracture.Methods A total of 100 patients admitted to the Department of OrthopedicsⅡof Zhongshan Hospital of Traditional Chinese Medicine in Guangdong Province and diagnosed with femoral intertrochanteric fractures from February 1,2018 to January 31,2021 were selected and divided into two groups by random number table method,with 50 patients in each group.50 patients received routine preventive treatment of subcutaneous LMWH injection for anticoagulation as the control group,while the remaining 50 patients received routine subcutaneous LMWH injection for anticoagulation plus oral administration of Tianqi oral liquid prepared by our hospital as the treatment group.The blood coagulation-related indexes,lower extremity ultrasound blood flow velocity and lower extremity pain score of patients before and after receiving the preventive treatment were compared between the two groups,and the rates of lower extremity swelling,deep venous thrombosis,and pulmonary embolism after receiving the preventive treatment were counted.Other complications that occurred during the patients’hospitalization were also compared between the two groups.Results After preventive treatment,the four indexes of D-D and blood coagulation and platelet levels in the two groups were significantly changed,among which D-D,PT,APTT,TT and platelet levels were lower than those before preventive treatment,the treatment group was lower than that of the control group,and the Fbg level was higher.Compared with before treatment,the treatment group was higher than the control group,and the difference was statistically significant(P<0.05).The lower extremity ultrasound hemodynamic indexes and lower extremity pain scores of the two groups of patients were significantly changed.The lower extremity ultrasound hemodynamic indexes were higher than those before preventive treatment,the treatment group was higher than that of the control group,and the lower extremity pain scores decreased compared with those before preventive treatment.The treatment group was lower than the control group,and the difference was statistically significant(P<0.05).After preventive treatment,the incidence of lower limb swelling and deep venous thrombosis in the treatment group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Statistical significance(P>0.05).The total incidence of other complications in the treatment group was slightly lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion In patients with femoral intertrochanteric fractures,the preventive treatment with Tianqi oral liquid combined with LMWH can significantly improve the patients’coagulation indexes,increase the lower extremity blood flow velocity,and reduce the swelling and pain of the lower extremities,thus reducing the occurrence of lower extrem ity deep venous thrombosis.