益气活血化瘀法干预老年股骨干骨折患者术后高凝状态临床研究

目的 观察益气活血化瘀法对老年股骨干骨折患者术后高凝状态的影响。方法 将60例老年股骨干骨折患者随机分为中药组和西药组各30例，两组均采用闭合穿针髓内钉治疗，中药组术后给予益气活血化瘀法治疗，西药组给予利伐沙班治疗，比较两组干预前后D-二聚体、凝血酶原时间（prothrombin time，PT），血小板计数（platelet count，PLC）以及患肢周径的变化。结果 两组患者术后凝血指标均较术前明显降低，差异均有统计学意义（P＜0.05）；两组手术前后凝血指标差值比较，差异无统计学意义（P>0.05）。两组术后均无下肢静脉血栓发生。中药组干预前后患肢周径的变化值大于西药组，差异有统计学意义（P<0.05）。结论 益气活血化瘀法与利伐沙班均能改善股骨干骨折患者术后的高凝状态，预防DVT的发生，但益气活血化瘀法治疗效果优于利伐沙班。

Clinical Effect of Qi-tonifying, Blood-activating, and Stasis-resolving Method on Hypercoagulability after Femoral Shaft Fracture Surgery in Elderly Patients

Objective To investigate the effect of qi-tonifying, blood-activating, and stasis-resolving method on hypercoagulability after femoral shaft fracture surgery in elderly patients. Methods A total of 60 elderly patients with femoral shaft fracture were randomly divided into traditional Chinese medicine (TCM) group and Western medicine group. All patients underwent closed insertion of intramedullary nail. The patients in the TCM group were treated with the qi-tonifying, blood-activating, and stasis-resolving method, and those in the Western medicine group were given rivaroxaban. The two groups were compared in terms of D-dimer level, prothrombin time (PT), platelet count (PLC), and change in circumference of the affected limb before and after the treatment. Results Both groups had significant reductions in coagulation indices after surgery (P<0.05), and there were no significant differences in coagulation indices between the two groups before and after treatment (P>0.05).No patient experienced deep venous thrombosis in lower limbs after surgery. The TCM group had a significantly greater change in circumference of the affected limb after intervention compared with the Western medicine group (P<0.05). Conclusion Both the qi-tonifying, blood-activating, and stasis-resolving method and rivaroxaban can improve hypercoagulability in patients with femoral shaft fracture after surgery and prevent deep vein thrombosis, but the qi-tonifying, blood-activating, and stasis-resolving method has a better clinical effect than rivaroxaban.