| Objective: This project analyzes the effects of Shentong Zhuyu Decoction on the coagulation function parameters,blood cell parameters and the incidence of deep vein thrombosis of the lower limbs after PFNA surgery in elderly patients with intertrochanteric fractures through clinical research,and explores the effect of Shentong Zhuyu Decoction on elderly intertrochanteric fractures whether it is feasible,safe and effective to improve the coagulation function after PFNA,it will give full play to the advantages of traditional Chinese medicine in the prevention and treatment of diseases,and provide a reference for clinical prevention of perioperative complications in orthopedics.Methods: In strict accordance with the inclusion and exclusion criteria of the trial design,60 elderly patients with intertrochanteric fractures who underwent PFNA operation were selected from the Department of orthopedics and hand surgery,Ruikang Hospital Affiliated to Guangxi University of traditional Chinese medicine from June 2019 to January 2021.According to the admission time sequence,the patients were randomly divided into treatment group and control group,30 cases in each group.The control group was treated with low molecular weight heparin calcium subcutaneous injection anticoagulant therapy,the treatment group was treated with low molecular weight heparin calcium subcutaneous injection combined with oral Shentong Zhuyu Decoction anticoagulant therapy,the other general treatment and postoperative functional exercise of the two groups were the same,the course of treatment was 14 days.The coagulation parameters(including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen content(FIB),international normalized ratio(INR),D-dimer),platelet count parameters and the incidence of DVT of lower limbs were recorded and analyzed at different time points before operation and on the 1st,7th and 14 th day after operation The data were analyzed and the differences of different time parameters between the two groups were compared to evaluate the efficacy of Shentong Zhuyu Decoction.Results:1.There was no statistically significant difference between the two groups of patients in general data(age,sex,fracture site)before operation(P>0.05).2.There was no significant difference in PT,APTT,TT,FIB,and INR values between the two groups of patients before and on the first postoperative day(P>0.05);the two groups of patients on the seventh and14 th day after surgery,PT,APTT The values of TT,INR were higher than those on the first day after surgery,and the treatment group was higher than the control group.The difference between the groups was statistically significant(P<0.05);After the first day,they all decreased,the treatment group was lower than the control group,and the difference between the groups was statistically significant(P<0.05).3.There was no significant difference in the D-dimer value between the two groups of patients before operation,on the 1st and 7th day after operation(P>0.05).The D-dimer value of the two groups was compared on the 14 th day after operation.It decreased on the 1st and 7th day after operation,the treatment group was lower than the control group,and the difference between the groups was statistically significant(P<0.05).4.The PT,APTT,TT,FIB,and D-dimer values of all patients were compared with those on the first day after the operation.The difference was obvious.On the first day after the operation,the PT,APTT,and TT were shorter than those before the operation.FIB,D-Dimer was higher than that before operation,and the difference was statistically significant(P<0.05).5.There was no statistically significant difference in platelet counts between the two groups of patients before operation and on the 1,7,and14 days after operation(P>0.05);during the test period,3 patients in the control group developed deep vein thrombosis in the lower extremities.Treatment There was no significant difference in the incidence of deep venous thrombosis in the lower extremities between the two groups(P>0.05).Conclusions:This test shows that the changes in blood coagulation function in elderly patients with intertrochanteric fractures after PFNA treatment include: shortening of PT,APTT,TT,INR values,increased FIB value and D-dimer value,and the blood is in a hypercoagulable state.;On the basis of subcutaneous injection of low-molecular-weight heparin calcium anticoagulation therapy,combined with oral Shentong Zhuyu Decoction,it will effectively improve the patient’s blood coagulation function,effectively reduce the concentration of D-dimer in the blood,improve the blood hypercoagulable state,and reduce blood viscosity Compared with the low-molecular-weight heparin calcium anticoagulation therapy,it is more effective and does not reduce the platelet concentration.It is worthy of further in-depth study and popularization in clinical practice. |
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