低分子肝素钙联合银杏达莫对股骨粗隆间骨折术后患者凝血功能及血液流变学的影响

Effect of Low Molecular Weight Heparin Calcium Combined with Ginkgo Biloba Extract and Dipyridamole on Coagulation Function and Hemorheology in Patients with Intertrochanteric Fracture after Operation

研究低分子肝素钙联合银杏达莫对股骨粗隆间骨折术后患者凝血功能及血液流变学的影响.方法:本次研究对象选取天津市静海区医院于2019年12月-2020年10月收治的股骨粗隆间骨折患者101例,使用随机数字表法将研究对象分为2组,即对照组和观察组.2组患者均在入院后接受手术治疗,对照组患者术后使用低分子肝素钙注射液进行抗凝血治疗,观察组在此基础上联合使用银杏达莫注射液进行抗凝血治疗,2组均持续10天抗凝血治疗.比较2组患者治疗前与治疗后10天患肢最大周径及肿胀率、凝血功能及血液流变学水平.结果:2组患者治疗前与治疗后10天髌骨上极上15 cm、髌骨下极下15 cm的周径与肿胀率、血浆PT、血浆APPT水平相比差异均无统计学意义(P>0.05);但治疗后10天观察组血浆PT、血浆AP-PT水平均显著高于对照组;2组患者血浆D-D水平较治疗前明显降低,且观察组低于对照组;与治疗前相比,治疗后10天,2组患者LS、HS、PV、PCV等血流动力学水平均明显降低,且观察组低于对照组(均P<0.05).治疗优良率对照组和观察组分别为70.00%、96.08%,观察组高于对照组,差异显著具备统计学意义(P<0.05).治疗干预前2组患者髋关节功能、疼痛评分比较(P>0.05),治疗干预后2组患者髋关节功能评分均升高,疼痛评分均降低,观察组低于对照组(P<0.05).观察组的下肢深静脉血栓、压疮、肺栓塞、内固定断裂等并发症总例数为3例(5.88%),明显低于对照组11例(22.00%),差异显著具备统计学意义(P<0.05).结论:低分子肝素钙联合银杏达莫能有效改善股骨粗隆间骨折患者血液流变学水平,降低血液凝固性,疗效更佳.

To study the effect of low molecular weight heparin calcium combined with Ginkgo biloba on coagulation function and hemorheology in patients with femoral intertrochanteric fractures.Methods:In this stud-y,101 patients with femoral intertrochanteric fractures who were admitted to Jinghai District Hospital in Tianjin from December 2019 to October 2020 were selected,and the subjects were divided into two groups by random number ta-ble method,namely the control group and the therapy group.Both groups of patients received surgical treatment after admission.The patients in the control group were treated with low molecular weight heparin calcium injection for anti-coagulant treatment after operation.On this basis,the patients in the treatment group were treated with Ginkgo Damo injection for anticoagulant treatment.Anticoagulant therapy was continued for 10 days.The maximum circumference,swelling rate,coagulation function and hemorheology of the affected limb were compared between the two groups be-fore treatment and 10 days after treatment.Results:There were no significant differences in the circumference and swelling rate,plasma PT and plasma APPT levels of 15 cm above the upper pole of the patella and 15 cm below the lower level of the patella between the two groups before treatment and 10 days after treatment(P>0.05).However,10 days after treatment,the plasma PT and plasma APPT levels of the treatment group were significantly higher than those of the control group;the plasma D-D levels of the two groups of patients were significantly lower than those before treatment,and the treatment group was lower than the control group;The hemodynamic levels of LS,HS,PV,PCV in the two groups were significantly decreased,and the treatment group was lower than the control group(all P<0.05).The excellent and good rates of treatment in the control group and the observation group were 70.00%and 96.08%,respectively,and the observation group was higher than the control group,and the difference was statisti-cally significant(P<0.05).Comparison of hip joint function and pain scores between the two groups before treat-ment and intervention(P>0.05),after treatment and intervention,the hip joint function scores of the two groups were increased,and the pain scores were decreased,and the observation group was lower than the control group(P<0.05).The total number of complications such as deep vein thrombosis,pressure ulcer,pulmonary embolism and internal fixation rupture in the observation group was 3 cases(5.88%),which was significantly lower than 11 cases(22.00%)in the control group,and the difference was statistically significant(P<0.05).Conclusion:Low mo-lecular weight heparin calcium combined with Ginkgo Damole can effectively improve the blood rheology level and re-duce blood coagulation in patients with femoral intertrochanteric fracture,and the curative effect is better.