| ObjectiveTo investigate the effective and necessity of TCM in the early application of deep vein thrombosis of hip fracture.MethodsThe study included 75 patients with hip fracture(femoral neck fracture and femoral intertrochanteric fractures)which met the inclusion criteria from October 2015 to December 2017.Those patients were randomized into control group,full course group(full course)and postoperative medication group(postoperative group)by a prospective,single-blind,randomized controlled design,each group 25 cases.Control group:Preoperative and postoperative conventional lower extremity deep venous thrombosis prevention methods+the heparin calcium injection was subcutaneously injected after surgery till one week after surgery.Full course group:Preoperative and postoperative use of conventional lower extremity deep venous thrombosis prevention methods after admission to the Chinese medicine-oriented transdermal therapy in the ipsilateral calf gastrocnemius and thigh after Lateral,twice daily for one week after surgery+the heparin calcium injection was subcutaneously injected after surgery till one week after surgery.Postoperative group:Preoperative and postoperative routine lower extremity deep venous thrombosis prevention methods+on the day after the beginning of the Chinese medicine to give directional drug therapy in the ipsilateral calf gastrocnemius and thigh The medial and lateral,twice daily,lasted until one week after surgery+the second day after the operation of the heparin calcium injection was subcutaneously injected after surgery till one week after surgery.Three groups of patients were monitored on the day after admission,one day before surgery,one day after surgery and one week after surgery to monitor the four coagulation and D2 aggregates.On the day of admission,one day before operation and one week after operation,patients underwent bilateral lower extremity arteriovenous Color Doppler ultrasound was used to observe the change of thrombus change of the thickest 10cm circumference of the patella above the patella and the calf at one week after admission.Through the establishment of a database and the use of statistical methods to analyze the indicators of three groups of patients objectively evaluate the effective and safety of directional percutaneous transdermal drug therapy in the prevention of perioperative deep venous thrombosis in elderly patients with hip fracture.There was no significant difference between the three groups in comparing the 10cm swelling rate.Results1.According to R X C chi-square analysis,there was no significant difference in preoperative gender,disease location,disease type,combined disease,anesthesia and operation material among the three groups(P>0.05)Analysis and test showed that there was no significant difference in the age,BMI,operation time,blood loss,APTT,D2 aggregates,PT,TT and FIB between the three groups before operation(P>0.05)Comparable.2.According to R X C chi-square analysis,there was significant difference in the number of deep venous thrombosis between the three groups(P<0.05).3.The APTT,PT,TT data of the three groups of patients satisfied with the normal distribution and homogeneity of variance test.The analysis of variance of repeated data showed the influence of time factor on the changes of APTT,PT,TT data(P<0.05).The values of APTT,PT,TT at different time points did not differ with the groups,and the difference was not statistically significant(P>0.05).Repeated measures showed that there was no significant difference among the three groups at different time points(P>0.05).4.The analysis of variance of repeated data shows that the influence of time factor on the change of D2-dimers data in each group is statistically significant(P<0.05).Repeated measurement analysis of variance showed that the three groups had statistical significance at the same time point after the 7th day of the three groups(P<0.05);the two were analyzed by one-way,and the whole group was compared with the control group on the 7th day after operation.P=0.04<0.05,the difference was statistically significant;P=0.04<0.05 in the control group and the postoperative group,the difference was statistically significant;P=0.64>0.05 in the full and postoperative group,the difference was not statistically significant.5.The analysis of variance of repeated data shows that the influence of time factors on the changes of FIB data in each group is statistically significant(P<0.05).Repeated measurement analysis of variance revealed that the three groups were statistically significant at the same time point on the 7th day after surgery(P<0.05);the whole course was compared with the control group 1 week after surgery.P=0.03<0.05,statistically significant;the difference between the whole group and the postoperative group P=0.03<0.05 was statistically significant;the difference between the control group and the postoperative group was P=0.04<0.05,and the difference was statistically significant.The average value of the whole Chinese medicine-orientated group was lower than that of the postoperative group and the control group.6.The three groups of the thickest 10cm circumference of the patella above the patella data satisfy the normal distribution and homogeneity of variance test.The analysis of variance of repeated data shows that the time factor has statistical significance(P<0.05);the leg circumference The difference was not statistically significant(P>0.05).Repeated measures of variance analysis shows that the three groups at different time points showed no significant difference(P>0.05).Conclusion1.In the control group of 25 cases,Postoperative blood flow slows down in 2 cases,3 cases occurred thrombosis,the incidence of thrombosis was 20%;25 cases of the whole group,0 cases of thrombosis occurred,the incidence of thrombosis 0%;25 cases of postoperative group,1 case of thrombosis occurred,the incidence of thrombosis 4%,There was a statistically significant difference between the three groups,indicating that the effect of TCM for prevention of hip deep venous thrombosis and nadroparin calcium injection during the whole course and after surgery was different.2.Throughout the use of traditional Chinese medicine directed peritoneal dialysis group on the 7th day postoperative FIB、D2-dimers index was significantly improved perioperative use of traditional Chinese medicine directed percutaneous hemodilution compared with Najadelphe heparin injection can improve blood hypercoagulability and promote early Recovery,it is worth promoting in clinical application.3.The use of traditional Chinese medicine targeted drug group on the 6th day after surgery for the 10cm above the cheekbones,calf at the thickest peripheral diameter to reduce the role,thereby promoting the body swelling. |
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