八味伤科活血片对髋部周围骨折后血液高凝状态影响的临床研究

【目的】探究八味伤科活血片干预髋部周围骨折后血液高凝状态的临床疗效。【方法】将72例血液学检查处于高凝状态的髋部周围骨折患者随机分成治疗组和对照组各36例,2组均给予骨科基础治疗,包括抬高患肢、患处外敷活血止痛膏、指导患肢功能锻炼等,在此基础上,治疗组给予八味伤科活血片+低分子肝素钙注射液治疗,对照组给予低分子肝素钙注射液治疗,观察2组用药前后血浆D-二聚体(D-Di)、血管性假性血友病因子(v WF)等高凝指标的变化及深静脉血栓形成(DVT)发生率。【结果】(1)2组病例全部完成医院内临床研究,均未发现出血增多及其他严重不良事件。(2)入院当天,2组病例血浆D-Di、v WF水平均高于正常水平,经用药后,于术前1天均显著降低(P0.05),术后第1天均较术前显著升高(P0.05),术后第12天均较术后第1天显著降低(P0.05),治疗组在改善血浆D-Di、v WF水平方面均优于对照组(P0.05)。(3)随访3个月,72例患者中61例获得随访,失访11例,其中治疗组31例、对照组30例获得随访;治疗组的DVT发生率为9.68%,对照组为16.67%,差异无统计学意义(P0.05)。【结论】八味伤科活血片可明显改善髋部周围骨折后血液高凝状态,骨折早期就能应用,使用方便,作用确切,并能降低抗凝药物用药风险;八味伤科活血片+低分子肝素钙对预防DVT有一定作用。

Effects of Bawei Shangke Huoxue Tablets on Hypercoagulable State of Patients with Hip Fracture

Objective To explore the effects of Bawei Shangke Huoxue Tablets on hypercoagulable state of patients with hip fracture. Methods Seventy-two hip fracture patients at hypercoagulable state were randomly divided into treatment group and control group, 36 cases in each group. Both groups were given conventional orthopedic treatment including raising up the affected limb, external application of Huoxue Zhitong Paste on the affected area, and instructions for affected limb functional exercise. Additionally, the treatment group was given oral use of Bawei Shangke Huoxue Tablets together with subcutaneous injection of low-molecular-weight heparin calcium, and the control group was given subcutaneous injection of low-molecular-weight heparin calcium. Before and after treatment, we observed the plasma D-dimer (D-Di) and blood von Willebrand factor(vWF) levels as well as the incidence of deep venous thrombosis (DVT) of both groups before and after treatment. Results (1) All of the cases of both groups completed the clinical trial, and no severe adverse reaction such as increased bleeding occurred. (2) On the admission day, the D-Di and vWF levels of both groups were higher than the normal levels, and were decreased obviously one day before the operation (P < 0.05). On the first post-operative day, the levels were increased as compared with those before operation (P < 0.05), and then decreased on the twelfth post-operative day (P < 0.05) compared with those on the first post-operative day). The treatment group had better effect on improving D-Di and vWF levels than the control group (P < 0.05). (3) The results of follow-up for 3 months showed that 61 cases got the follow-up, 31 cases from the treatment group and 30 from the control group. The DVT incidence of treatment group was 9.68% and that of the control group was 16.67%, the difference being insignificant(P>0.05). Conclusion Bawei Shangke Huoxue Tablets are effective on improving hypercoagulable state of patients with hip fracture, and can be used at early stage and are beneficial to lowering the risks of anticoagulant drugs. Bawei Shangke Huoxue Tablets plus low-molecular-weight heparin calcium have certain effect on preventing DVT.