中药封包结合推拿预防股骨粗隆间骨折术后下肢深静脉血栓等并发症临床研究

Clinical Study on Prevention of Complications such as Deep Venous Thrombosis in Lower Limbs After Operation Femoral Intertrochanteric Fracture by Applying Hot Compress with Chinese Medicine Package Combined with Tuina

目的:观察中药封包结合推拿预防股骨粗隆间骨折术后下肢深静脉血栓等并发症的临床疗效。方法:按随机数字表法将108例股骨粗隆间骨折术后患者分为对照组和观察组各54例。对照组采用低分子肝素钙治疗预防下肢深静脉血栓,观察组在对照组基础上予以中药封包结合推拿治疗。比较2组术前、术后凝血指标及D-二聚体(D-D)水平、患肢大腿周径,并比较2组下肢深静脉血栓发生率。结果:术后7 d、术后2周,2组凝血酶原时间(PT)、部分凝血酶活酶时间(APTT)水平均逐渐升高(P<0.05),且同一时间点观察组高于对照组(P<0.05)。术后7 d,2组D-D水平升高(P<0.05),但观察组低于对照组(P<0.05);术后2周,2组D-D水平较术后7 d降低(P<0.05),且观察组仍低于对照组(P<0.05)。术后3 d、7 d、2周,2组患肢大腿周径均较术前增大(P<0.05),但呈逐渐减小趋势(P<0.05),且同一时间点观察组小于对照组(P<0.05)。观察组下肢深静脉血栓发生率为1.85%,低于对照组12.96%(P<0.05)。治疗后,2组躯体健康、心理功能、社会功能及物质生活评分均升高(P<0.05),且观察组高于对照组(P<0.05)。结论:中药封包结合推拿治疗股骨粗隆间骨折术后患者可有效改善其术后凝血状态,减少术后下肢深静脉血栓的发生率,促进患者康复。

Objective:To observe the clinical effect of hot compress with chinese medicine package combined with tuina on preventing complications such as deep venous thrombosis in the lower limbs after operation femoral intertrochanteric fracture.Methods:A total of 108 cases of postoperative patients with femoral intertrochanteric fracture were divided into the control group and the observation group according to the random number table method,with 54 cases in each group.The control group received low-molecularweight heparin calcium treatment to prevent deep venous thrombosis in the lower limbs,and the observation group received hot compress with chinese medicine package combined with tuina based on the treatment of the control group.The preoperative and postoperative coagulation indexes,D-dimer(D-D)levels,and the affected limb and thigh circumference were compared between the two groups.The incidence of deep veinous thrombosis in the lower limbs was compared between the two groups.Results:At postoperative 7 days and 2 weeks,the levels of prothrombin time(PT)and activated partial thromboplastin time(APTT)were gradually increased in the two groups(P<0.05),and at the same time point,the level in the observation group was higher than that in the control group(P<0.05).At postoperative 7 days,the D-D levels in the two groups were increased(P<0.05),but the level in the observation group was lower than that in the control group(P<0.05).At postoperative 2 weeks,the D-D levels in the two groups were decreased when compared with those 7 days after surgery(P<0.05),and the level in the observation group was still lower than that in the control group(P<0.05).At postoperative 3 days,7 days,and 2 weeks,the thigh circumference of the affected limb in the two groups was increased when compared with that before surgery(P<0.05),but showed a gradual decrease trend(P<0.05),and at the same time,the one in the observation group was lower than that in the control group(P<0.05).The incidence of deep veinous thrombosis was 1.85%in the observation group,lower than that of 12.96%in the control group(P<0.05).After treatment,the scores of physical health,psychological function,social function,and material life in the two groups were increased(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05).Conclusion:Hot compress with chinese medicine package combined with tuina for patients after operation femoral intertrochanteric fracture can effectively improve the postoperative coagulation status,reduce the incidence of postoperative deep veinous thrombosis in the lower limbs,and promote patient recovery.