通脉饮联合利伐沙班对老年股骨粗隆间骨折术后下肢深静脉血栓形成因素影响

Effect of Tongmaiyin combined with rivaroxaban on factors of deep vein thrombosis of lower extremity after operation of intertrochanteric fracture of femur in elderly patients

目的分析通脉饮联合利伐沙班对老年股骨粗隆间骨折手术后下肢深静脉血栓形成的影响。方法对2022年1月一2023年1月解放军总医院第六医学中心收治的100例需要接受手术治疗的老年股骨粗隆间骨折患者住院期间数据进行分析,将其随机为试验组和对照组,每组各50例,2组在入院后完善相关检查,术后于麻醉恢复室观察,经麻醉科医师评估后送至病房行一般生命体征的动态监护。术后对照组予以利伐沙班治疗,试验组在此基础上予以通脉饮治疗。2组均治疗35d,术后随访1个月。观察2组下肢情况和相关实验室指标变化情况,并记录2组下肢术后静脉血栓栓塞症发生率及术后服药期间的不良反应。结果2组术后10d、15d,试验组下肢周径差均小于对照组(t=5.781~17.295,P均<0.001)。经相同干预时间7d后,试验组血凝相关指标和血液流变学指标均优于对照组(t=2.047~5.021,P均<0.05)。出院后随访,试验组有6例发生出血事件,2例发生下肢深静脉血栓;对照组有9例发生出血事件,8例发生下肢深静脉血栓(χ^(2)=0.706、4.000,P=0.401、0.046)。结论通脉饮联合利伐沙班有利于降低老年患者术后风险,促进患者转归。

Objective Analysis of the Effects of Tongmai Drink and Rivaroxaban on Postoperative Lower Extremity Deep Vein Thrombosis Formation in Elderly Patients with Intertrochanteric Fractures.Methods Data from 1o0 confirmed patients treated from January 2022 to January 2023 were analyzed in the Sixth Medical Center of the General Hospital of the People's Liberation Army.The patients were randomly divided into a study group and a control group,with 50 patients in each group.After admission,both groups underwent complete examinations,and post-surgery observations were made in the anesthesia recovery room.Following assessment by an anesthesiologist,patients were transferred to the ward for dynamic monitoring of vital signs.Postoperatively,the control group received Rivaroxaban,while the study group received Tongmai Drink in addition to Rivaroxaban.Both groups were treated for 35 days and followed up one month after surgery.The conditions of the lower limbs and changes in relevant laboratory indicators were observed,and the incidence rates of postoperative venous thromboembolism and adverse drug reactions during the medication period were recorded.Results On the 10th and 15th day after surgery in both groups,the lower limb circumference difference in the study group was smaller than that in the control group(t=5.781~17.295,all P<0.001).After the same intervention time of 7 days,the coagulation related indicators and hemorheological indicators in the study group were better than those in the control group(t=2.047~5.021,all P<0.05).Follow up after discharge showed that 4 cases in the study group had bleeding events,3 cases had deep vein thrombosis in the lower limbs;7 cases in the control group had bleeding events,and 10 cases had deep vein thrombosis in the lower limbs(x=0.706,4.000,P=0.401,0.046).Conclusion The combination of Tongmai Drink and Rivaroxaban is beneficial for reducing postoperative risk in elderly patients,thereby promoting better patient outcomes.