| Objective: In this study,we conducted clinical observation on elderly patients after PFNA of femoral intertrochanteric fracture by administering Fuyuan Revitalizing Blood Soup plus reduction combined with low-molecular heparin calcium to evaluate its effect on the prevention of blood hypercoagulability in the lower limbs and provide a new direction for clinical thinking on the prevention of blood hypercoagulability in the lower limbs.Methods: Fifty elderly patients with femoral intertrochanteric fracture and internal fixation surgery who met the diagnostic and inclusion criteria and were hospitalized in the Department of Orthopedics of the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine between January 2021 and January 2023 were selected and grouped into experimental and control groups by random number table method,with 25 cases each.Both groups were given the same treatment before surgery,and the surgery was performed by the same team of physicians.After surgery,the control group was treated with low-molecular heparin anticoagulation therapy,and the experimental group was given Fuyuan Blood Activation Tang plus reduction on top of that.D-dimer,plasma prothrombin time(PT),activated partial thromboplastin time(APTT),VAS score,and bilateral thigh and calf circumference difference were assessed on postoperative day 1,postoperative day 7,and postoperative day 14 in the two groups,respectively.At the end of the study,the data collected were statistically analyzed using the statistical software SPSS 27.0.Results:1,Statistical analysis of gender,age,and surgical site of the two groups of patients included in the study,and the differences were not statistically significant.2,D-dimer(D-dimer): There was no statistically significant difference in D-dimer index between the two groups on the first postoperative day(P > 0.05);the experimental group was lower than the control group on the seventh and fourteenth postoperative days(P <0.05).3,plasma prothrombin time(PT)and activated partial thromboplastin time(APTT): there was no statistically significant difference between the PT and APTT indexes of the two groups on postoperative day 1(P>0.05);the experimental group was better than the control group on postoperative day 7 and day 14(P<0.05).4,VAS pain score: the difference in VAS pain score values between the two groups on the first postoperative day was not statistically significant(P>0.05);the VAS score values on the seventh postoperative day and the fourteenth postoperative day in the experimental group were lower than those in the control group(P<0.05).5.The difference between the circumference of the healthy and affected thighs: the difference between the circumference of the healthy and affected thighs of the two groups on the first postoperative day was statistically verified to be not statistically significant(P > 0.05);comparing the difference between the circumference of the healthy and affected thighs of the two groups on the seventh and fourteenth postoperative days,the experimental group was better than the control group,and the difference was statistically significant(P<0.05).6,healthy and affected side calf circumference difference: the difference between healthy and affected side calf circumference in the first postoperative day of the two groups was not statistically significant(P>0.05);comparing the two groups in the seventh postoperative day and the 14 th postoperative day,the difference between healthy and affected side calf circumference decreased compared with the first postoperative day,and the study group had better effect than the control group,and the difference was statistically significant(P<0.05),indicating that Fuyuan Revitalizing Blood Tang plus reduction was effective in reducing swelling.7,incidence of thrombosis: a total of 50 patients in both groups underwent vascular ultrasound of both lower limbs on postoperative day14,one case of DVT occurred in the control group and no confirmed case in the experimental group,with a total incidence of 2%.8、Safety analysis: In both groups,no serious adverse events such as bleeding from important organs and pulmonary embolism occurred during the treatment,and only 2 cases of blood oozing from the operation port occurred in the control group,and the difference was not statistically significant(P>0.05).Conclusion(s):(i)the use of Fuyuan Revitalizing Blood Soup with addition and reduction can reduce the D-dimer level;(ii)the use of Fuyuan Revitalizing Blood Soup with addition and reduction intervention can prolong the PT and APTT time;(iii)the use of Fuyuan Revitalizing Blood Soup with addition and reduction can alleviate a certain degree of pain and swelling manifestation and enhance the efficacy without increasing the risk of medication use.It can be concluded that Fuyuan Revitalizing Blood Soup with addition and reduction can effectively prevent the formation of blood hypercoagulable state after femoral intertrochanteric fracture in the elderly. |
PDF Full Text Request