| ObjectiveIn order to provide a more effective and safer prophylactic solution for postoperative deep vein thrombosis (DVT) in senile patients with major fractures, according to my tutor’s clinical experience and TCM theory of activating blood circulation and expelling stasis, we investigated the impacts of Panax notoginsenq saponins on the clotting indices and the bony metabolic markers on senile patients with osteoporotic intertrochanteric fractures.MethodsBased on clinical research methodology, from January2013to January2014, sixty cases of osteoporotic unilateral intertrochanteric fracture hospitalized in the Traumatic and Orthopedics Hospital affiliated to Guangzhou University of T. C. M., who needed to undergo PFNA procedures and eligible to our standards of research, were enrolled as research objects. The patients were grouped randomly into two groups, with30cases in each group:the Group Treatment, in which the patients were treated with intravenous infusion of Xueshuantong Injection (ingredient:Panax notoginsenq saponins, Wuzhou Pharmaceutical Group Co., Ltd. Guangxi.250mg/bottle)250mg with250ml of normal saline each time, from the operating date, once daily, lasting for two weeks;and the Group Control, in which the patients were injected subcutaneously with low molecular weight heparin(LMWH).(Hongri Pharmaceutical Co. Ltd. Tianjin.3000U),3000U each time, also from the operating date,once a day, lasting for two weeks. Four clotting indices, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB)and D-dimer (DDI),and three bone metabolic markers, including the total amino-terminal extension propeptide of type Ⅰ procollagen(T-PINP), beta-collagen degradation products(β-Crosslaps) and N-middle osteocalcin (N-MID) were detected before and after the administrations of the two drugs. Clinical examinations and venous ultrasonography were performed after the courses to determine whether DVT occur or not. Intertrochanteric fractures were treated with closed reduction and PFNA fixation procedure.ResultThe outcomes of this study manifest that after the medications, the serum PT and APTT were prolonged, and, serum FIB and DDI levels were lower in the two groups, but the differences before and after the uses of medicines were not statistically significant, the differences between two groups were not statistically significant neither;After the treatments, in both groups, T-PINP, β-Crosslaps and N-MID were slightly elevated, without statistical difference before and after the treatments, furthermore, the difference between groups was not statistically significant. However, the relieving of swelling and pain of injured thighs in the Group Treatment was quicker than that in the Group Control, with statistically significant difference between groups.The postoperative incidences of DVT in both groups were same (both2/30).Conclusion1、The Chinese herbal medicine Xueshuantong (Panax notoginsenq saponins)used alone for prophylaxis against DVT after PFNA procedure for osteoporotic intertrochanteric fractures can achieve the same effect and safety as LMWH.2、In aspects of relieving swelling and pain of fractured limbs,Xueshuantong (Panax notoginsenq saponins)is obviously superior toLMWH.3、In this study, the D-dimer levels were higher than the normal one in the two groups before and after the surgery. This phenomenon suggests that there are risks of DVT in senile severely fractured patients, and, it is necessary to take relevant precautions against DVT.4、Temporarily, the study did not show Xueshuantong (Panax notoginsenq saponins) and LMWH had any impact on bone metabolic markers. |
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