补阳还五汤联合低分子肝素对股骨转子间骨折术后凝血-纤溶系统的影响

目的：探讨补阳还五汤联合低分子肝素对股骨转子间骨折术后凝血一纤溶系统的影响。方法：采用前瞻随机对照临床试验设计方法。根据性别、年龄、手术时间、手术方式及Evens分型将80例股骨转子间骨折术后病例按照分层随机化的方法以1：1比例分成试验组、对照组。根据《中国骨科大手术静脉血栓栓塞症预防指南》，两组均皮下注射低分子肝素，同时试验组予补阳还五汤每日1剂，连续7d。分别观察两组受试对象试验前、试验后凝血一纤溶系统指标及伤肢彩色多普勒超声检查结果变化。结果：两组患者试验前凝血一纤溶系统指标比较，差异均无统计学意义（P〉0．05）；试验后比较，差异均有统计学意义（P〈0．05）。两组患者试验后伤肢彩色多普勒超声检查结果比较，差异有统计学意义（P〈0．05）。结论：补阳还五汤联合低分子肝素能够改善股骨转子间骨折术后血液高凝状态，激活纤溶系统，预防伤肢深静脉血栓形成，值得临床推广应用。

The Effect of Buyang Huanwu Decoction Combined with Low Molecular Weight Heparin on Coagulation Fibrinolysis system after the Surgery of Femoral Intertrochanteric Fracture

Objective：To explore the effect of Buyang Huanwu Decoction combined with low molecular weight heparin on co- agulation -- fibrinolysis system after the surgery of femoral intertrochanteric fracture. Methods： The prospective random- ized compared clinical trial design method was adopted. According to gender, age, operative time, surgical approach and E- vens＇classification, 80 cases were divided into experimental group and control group according to stratified randomization in proportion to 1 ： 1. According to （（ Guideline of venous thromboembolism prevention in Chinese major orthopedic surgery ）〉, both groups were treated with low molecular weight heparin subcutaneous injection. Simultaneously, experimental group was treated with Buyang Huanwu Decoction once daily for 7 days. Before and after the test , the two guroups were observed respectively on the changed results of coagulation-fibrinolysis system indices and the injured limb deep vein color Doppler uhrasonography. Results：There were no statistically significant differences in gender, age, operative time, surgical ap- proach and Evens classification between experimental group and control group （P~0.05）. There was no statistically sig- nificant difference in coagulation-fibrinolysis system indices between experimental group and control group before the test （P〉0.05） ,while there was statistically significant difference after the test （P〈0.05）. There was statistically significant difference in the injured limb deep vein color Doppler ultrasonography between experimental group and control group after the test （P〈0.05）. Coneiusion：Buyang Huanwu Decoction combined with low molecular weight heparin can improve blood hypercoagulable state after the surgery of femoral intertrochanteric , and activate fibrinolysis system, and prevent deep vein thrombosis with femoral intertrochanteric fracture after surgery. It is worthy of clinical application.