| ObjectiveIn this study,Bawei Shangke Huoxue tablets combined with low molecular weight heparin calcium were used to intervene the hypercoagulable state of blood in middle-aged and elderly patients after femoral shaft fracture surgery,and the related indexes before and after treatment were statistically analyzed to explore the effect of Bawei Shangke Huoxue tablets combined with low molecular weight heparin calcium on the hypercoagulable state of blood in middle-aged and elderly patients after femoral shaft fracture surgery,so as to provide a certain reference value for Chinese medicine to prevent the formation of deep vein thrombosis in elderly patients after femoral shaft fracture surgery.MethodsAccording to inclusion criteria and exclusion criteria,as a case of 62 patients with femoral shaft fractures,who were treated in Zhongshan Hospital of Traditional Chinese Medicine from January 2019 to December 2020.All of the patients were randomly and evenly assigned to treatment group and control group.Under the same treatment of basic treatment,the control group was given subcutaneous injection of low molecular weight heparin calcium,while the other was given oral Bawei Shangke Huoxue tablet + subcutaneous injection of low molecular weight heparin calcium.Blood samples were taken from all of these hospitalized patients to type D-dimer,plasma prothrombin time(PT)and fibrinogen(FIB),which were measured on the first day of admission,the first day,the third day and the seventh day after operation.The incidence of deep vein thrombosis was analyzed by color doppler ultrasound on the seventh day after operation.With the help of data analyzing,the changes of limb circumference difference,VAS(visual analogue scale of pain),complications such as fat embolism,pulmonary embolism,tension blister,drug allergy and adverse drug reactions were recorded.Results1.As a case of 62 patients,who were included in this study.2 patients fell off,60 patients completed the clinical trial.30 patients in the experimental group and 30 patients in the control group.Baseline comparison: there was no significant difference in gender,age,affected limb position,AO classification of fracture,waiting for surgery after admission and intraoperative blood loss between the two groups(P>0.05).2.The D-dimer of the two groups was higher than the normal value on the first day of admission,which is indicated that the blood entered the hypercoagulable state after fracture trauma.D-dimer and fibrinogen were compared between the two groups on the first day of admission(P>0.05).On the first day after operation,D-dimer and fibrinogen of the two groups reached the peak.Compared to the first day after operation,D-dimer and fibrinogen in the two groups decreased in the third day after operation(P<0.05).In compared with the control group,D-dimer and fibrinogen in the experimental group decreased more significantly than on the third day after operation(P <0.05).While on the third day after operation,D-dimer and fibrinogen in the two groups decreased significantly on the 7th day after operation(P<0.05).Compared with the control group,D-dimer and fibrinogen in the experimental group decreased more significantly on the 7th day after operation(P<0.05).3.On the first day of admission,prothrombin time was compared between the two groups(P>0.05).On the first day after operation,prothrombin time of the two groups decreased to the lowest value,and there was no significant difference between the two groups(P>0.05).Compared with the first day after operation,prothrombin time of the two groups increased obviously on the third day after operation(P<0.05).By contrast,the 3rd day after operation,prothrombin time of the two groups increased significantly on the 7th day after operation(P<0.05).Compared with the control group,the experimental group increased more significantly on the 7th day after operation(P<0.05).4.On the first day of admission,VAS score and limb circumference difference of the two groups increased,but there was no significant difference between the two groups(P>0.05).On the first day after operation,VAS score and limb circumference difference of the two groups increased to the highest value,and there was no significant difference between the two groups(P>0.05).On the third day after operation,the VAS score and the circumference difference of the affected limb of the two groups were significantly lower than those on the first day after operation(P<0.05),and there was no significant difference between the two groups(P>0.05).On the 7th day after operation,the VAS score and the circumference difference of the affected limb of the two groups were significantly lower than those on the 3rd day after operation(P<0.05),and the experimental group was better than the control group(P<0.05).5.On the 7th day after operation,one case of DVT occurred in the experimental group,proportion of 3.33%,and two cases of DVT occurred in the control group,accounting for6.66%,with no significant difference(P>0.05);during the experiment,one case of feces in the experimental group and one case of the gingival bleeding occurred in the control group,accounting for 3.33% and 3.33% respectively,with no significant difference(P >0.05).There were no nasal,gastrointestinal and skin bleeding,fat embolism,pulmonary embolism,tension blister,drug allergy and other complications in the two groups.The basic vital signs of the two groups were stable,and there were no serious adverse reactions such as systemic reactions..ConclusionBawei Shangke Huoxue tablets combined with low molecular weight heparin calcium injection can reduce D-dimer and fibrinogen,prolong prothrombin time,effectively improve blood hypercoagulability,and improve swelling and pain symptoms of affected limbs.It has definite clinical intervention effect and high safety,which is worthy of clinical promotion and application.In addition,Bawei Shangke Huoxue tablets may have the effect of preventing deep venous thrombosis,which needs large sample,multi center clinical research to determine its clinical efficacy. |
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