桃红四物汤加减预防Pilon骨折创伤围手术期下肢静脉血栓临床研究
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摘要
目的:观察桃红四物汤加减在Pilon骨折围手术期调控D-二聚体水平及预防下肢深静脉血栓中的疗效。方法:对收入我院的Pilon骨折患者进行随机分组,试验组予以口服桃红四物汤,对照组予以皮下注射低分子肝素钙,同时两组患者均予以双下肢空气波治疗、主动功能锻炼以预防血栓。动态监测D-二聚体水平及统计血栓发生率。结果:两组患者在人数、性别、年龄及骨折分型、软组织损伤情况分度等差异均无统计学意义(P>0.05),D-二聚体动态监测结果显示两组疗效无统计学意义(入院第2天,术前1天及术后3天、7天P值分别为0.603,0.757,0.362,0.675),血栓发生率统计无统计学差异(P=1)。结论:桃红四物汤加减可以有效的预防Pilon骨折围手术期血栓的发生。
Objective:To study the effect of Modified Taohong Siwu Decoction on regulating D-dimer and preventing DVT during peri-operative period of Pilon fracture. Methods:The hospitalized patients with PILON fracture in our hospital were randomly divided into two groups. The experimental group was given Modified Taohong Siwu Decoction orally and the controlled group was given?Low-Molecular-Weight Heparin Calcium Injection subcutaneously. The D-dimer level was monitored dynamically and thrombosis incidence was counted in the two groups. Results:There was no significant difference in the number,sex,age,fracture type and soft tissue injury between the two groups(P>0.05). Dynamic monitoring of D-dimer showed that there was no significant difference between the two groups(the P values on the 2~(nd) day in the hospital,the 1~(st) day before operation and the 3~(rd),7~(th) day after operation were 0.603,0.757,0.362,0.675,respectively) and the incidence of thrombosis was no statistical difference between the two groups(P=1). Conclusion:The Modified Taohong Siwu Decoction can effectively prevent the occurrence of thrombus during the perioperative period of Pilon fracture.
Objective:To study the effect of Modified Taohong Siwu Decoction on regulating D-dimer and preventing DVT during peri-operative period of Pilon fracture. Methods:The hospitalized patients with PILON fracture in our hospital were randomly divided into two groups. The experimental group was given Modified Taohong Siwu Decoction orally and the controlled group was given?Low-Molecular-Weight Heparin Calcium Injection subcutaneously. The D-dimer level was monitored dynamically and thrombosis incidence was counted in the two groups. Results:There was no significant difference in the number,sex,age,fracture type and soft tissue injury between the two groups(P>0.05). Dynamic monitoring of D-dimer showed that there was no significant difference between the two groups(the P values on the 2~(nd) day in the hospital,the 1~(st) day before operation and the 3~(rd),7~(th) day after operation were 0.603,0.757,0.362,0.675,respectively) and the incidence of thrombosis was no statistical difference between the two groups(P=1). Conclusion:The Modified Taohong Siwu Decoction can effectively prevent the occurrence of thrombus during the perioperative period of Pilon fracture.
引文
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[12] 杨秀娟,邓毅,杨志军,等.当归不同药用部位对急性血瘀模型大鼠的活血作用.中国临床药理学杂志,2018,34(18),2187～2190
[13] 李国山.蚓激酶降纤对缺血性脑卒中患者 D-二聚体及 CRP 水平的影响.慢性病学杂志,2016,17(4),349～350
[14] 杨燕菲,吴鹏.水蛭素治疗骨折后伴发下肢静脉血栓的临床疗效及可能机制.中国生化药物杂志,2016,36(6):173～175
[15] 陈廖斌,顾洁夫,王华,等.足踝主、被动运动对下肢静脉回流的影响等研究.中华骨科杂志,2001,21(3):145～147
[2] 张柏根,薛冠华.深静脉血栓形成的病因[J].中国实用外科杂志,2003,23,(4):197～200
[3] 许鸿鸿,止血带对胫腓骨骨折术后下肢深静脉血栓形成的影响.江西医药,2017,52(6),482～484
[4] Iorio A,Douketis J D.Ruling out DVT using the Wells rule and a D-dimer test[J].BMJ,2014,348:g1637
[5] Elf JL,Strandberg K,Nilsson C.Clinical probability assessment and D-dimer determination inpatients with suspected deep vein thrombosis,a prospective multicenter management study[J].Thromb Res,2009,123(4):612～616
[6] 邓长华.血浆D-二聚体对脊柱结核患者术后早期深静脉血栓形成的诊断价值[J].中国实验诊断学,2015,19(3):471～473
[7] Luxembourg B,Schwonberg J,Hecking C,et al.Performance of five D-dimer assays for the exclusion of symptomatic distal legvein thrombosis[J].Thromb Haemost.2012;107:369～378
[8] Kolady J,Davis R,George R,et al.Successful thrombolytic therapy for massive pulmonary embolism following abdominoplasty[J].Indian J Plast Surg,2013,46(3):600～601
[9] 张建方,金国强,姚航军,等.补阳还五汤加减预防髋关节置换术后深静脉血栓形成的临床研究[J].中医正骨,2013,25(2):19～21,24
[10] 韩庆松.活血通栓饮预防髋关节置换术后下肢深静脉血栓临床观察[J].新中医,2012,44(4):52～53
[11] 戴号,王凌椿,翟伟韬.加叶桃核承气汤预防人工全髋关节置换术术后下肢深静脉血栓的效果评价[J].四川中医,2012,30(10):68～70
[12] 杨秀娟,邓毅,杨志军,等.当归不同药用部位对急性血瘀模型大鼠的活血作用.中国临床药理学杂志,2018,34(18),2187～2190
[13] 李国山.蚓激酶降纤对缺血性脑卒中患者 D-二聚体及 CRP 水平的影响.慢性病学杂志,2016,17(4),349～350
[14] 杨燕菲,吴鹏.水蛭素治疗骨折后伴发下肢静脉血栓的临床疗效及可能机制.中国生化药物杂志,2016,36(6):173～175
[15] 陈廖斌,顾洁夫,王华,等.足踝主、被动运动对下肢静脉回流的影响等研究.中华骨科杂志,2001,21(3):145～147