Study On The Intervention Of Hypercoagulabale State In Hip Fracture Of Aged People With Jiawei Taohong Siwutang

Object:The blood hypercoagulabale state(HCS) is the pacing factor of pathological thrombosis,most hip fracture of aged people can induce hypercoagulabale.The deep vein thrombosis(DVT) and pulmonary embolism(PE) can be ruduced if precaution is taken in time.This study was to probe a intervention measure,which has little adverse reaction and can be used in earlier period.Jiawei Taohong Siwutang was given in early time after the fracture occurred,then the effect of intervention can be evaluated from clinical observation,and obtain the clinical evidence according to the study.Methods:From August,2008 to December,2008,the patients of hip fracture in elderly were checked when they just stayed in hospital,The pations whose D-dimer exceed 400ug/L were Selected,total 90 patients are divided into three groups which was based on the intervention measure,30 cases of each group,the Group A used the medicine of Jiawei Taohong Siwutang,Group B used the medicine of low molecular weight heparin(LMWH),and the Group C,taking with Yunnan bai yao and Sanqi pill,all patients took medicine for 7 days.The following parameters were measured,including whole blood platelet counts(PLC),plasma D-dimer and thromboelastography(TEG).Also observed before and after treatment in patients with the tongue,Sublingual venae,pulse.And also took the color dopier ultrasonography for patients' veins of lower extremities. Test results and statistical analysis.Results:(1) When three groups of patients were on admission,D-dimer were 1176.17ug/L±395.15 ug/L,1186.17 ug/L±356.76 ug/L,1046.30 ug/L±335.56 ug/L,Gradually decreased after treatment,To 7 days,Dropped to 361.70 ug/L±100.15 ug/L,386.43 ug/L±171.31 ug/L,849.07 ug/L±251.80 ug/L; Group A and Group B compared with Group C have significantly different,P< 0.01;(2)Three groups' PLC increased after fractured,the first day,PLC Were 220.57×10~9±37.88×10~9,215.77×10~9±41.05×10~9,198.50×10~9±50.92×10~9, To 7 days,PLC were 290.97×10~9±10.27×10~9,288.80×10~9±21.24×10~9,329.03×10~9±22.52×10~9,Group A and Group B compared with Group C have significantly different,p<0.01;(3)TEG observation:The formation angle which is On behalf of the solidification rate of thrombin(αangle,normal 14-46°),the first day, 41.32°±10.86°,42.16°±9.91°,41.32°±9.54°,To 7 days,to 45.34°±9.91°,47.92°±8.94°,50.34°±8.90°。Thrombosis most significantly(MA,normal 42-63mm),the first and seventh days were 56.84mm±7.48mm,55.08mm±7.54mm,56.63mm±7.33mm, 62.11mm±9.16mm,61.63mm±9.90mm,63.34mm±9.05mm;G value(normal 3.2 -7.1d/sc),the first day were 7.19 d/sc±1.57d/sc,7.36 d/sc±1.72d/sc,7.33 d/sc±1.54d/sc,To 7 days,G value were 9.72d/sc±2.27d/sc,9.83 d/sc±2.38d/sc,10.00d/sc±2.35d/sc。(4) No obvious thrombosis were find when three groups of patients were on admission,after 7 days,7 cases of DVT were find after Color Doppler examination,Group A and Group B have 1 case,Group C have 5 cases.1 case was Femoral vein thrombosis,and 6 cases were Three intramuscular small calf vein thrombosis,The incidence of DVT was 7.8%.C group was significantly higher than the other two groups.Conclusion:The coagulation of elderly patients enhanced after hip fracture,most of them were hypercoagulable state;Jiawei Taohong Siwutang can reduce the plasma D-dimer,lower the incidence of DVT and hypercoagulable state; In our clinical study,it can be find that Jiawei Taohong Siwutang group can lower related indicators of HCS More obviously than sanqi pill and yunnan baiyao group.There is no obviously adverse reaction of Jiawei Taohong Siwutang, it is particularly applicable to the early post-fracture treatment of hypercoagulable state.Combined with the literature,Jiawei Taohong Siwutang can also accelerate the speed of blood flow and reduce blood viscosity; dissolution or prevention ofthrombosis;improve microcirculation; anti-fatigue and the role of hypoxia.