Clinical Study Of Panax Notoginseng Combined With Tranexamic Acid In The Treatment Of Latent Blood Loss After PFNA In Elderly Patients With Intertrochanteric Fractures

Objective: The effect of Panax notoginseng combined with tranexamic acid in the treatment of aged intertrochanteric fracture with hidden blood loss after PFNA,to provide partial theoretical basis for the application of Panax notoginseng powder in the treatment of aged intertrochanteric fracture with invisible blood loss.The second is to demonstrate the safety of combination use and the potential to reduce the risk of thrombosis and associated complications.Methods: The clinical observation subjects of this study were 62 patients with intertrochanteric fracture who were admitted to the Department of Bone Trauma,Affiliated Hospital of Traditional Chinese Medicine,Southwest Medical University from February 2019 to October 2020.Patients were screened strictly according to the inclusion and exclusion criteria.According to the random number table method,the subjects were divided into the experimental group and the control group.The experimental group began to take notoginseng powder 1 day before surgery,3g once,and water infusion,twice a day,until the 7th day after surgery.On the day of operation,tranexamic acid was added to 100 m L of normal saline at a dose of 15mg/kg and intravenously dripping within 15 minutes before skin cutting,and the same dose of tranexamic acid was intravenously dripping again 3 hours later.The control group began to take starch 1 day before surgery,3g once,water infusion,twice a day,until the 7th day after surgery.Tranexamic acid was added to 100 m L of normal saline at a dose of15mg/kg on the day of operation and intravenously dripping within 15 minutes before skin cutting.The same dose of tranexamic acid was intravenously dripping again 3hours later to observe the total blood loss,hidden blood loss,D-dimer and the incidence of complications in patients after PFNA.RESULTS: There was no statistical significance in the comparison of general data,such as age,height,weight,operation time,preoperative hemoglobin and hematocrit between the two groups(P>0.05),which showed comparability.Comparison of dominant blood loss,hidden blood loss and total blood loss between the two groups: the dominant blood loss in the experimental group was(315.34±51.36)ml,and the dominant blood loss in the control group was(338.82±61.85)ml,and there was no significant difference in the dominant blood loss between the two groups(P>0.05).The latent blood loss and total blood loss in the experimental group were(415.34±41.36)ml and(758.45±63.30)ml,respectively,while the latent blood loss and total blood loss in the control group were(525.57±36.32)ml and(795.70±51.29)ml,respectively.The total blood loss and latent blood loss in the experimental group were significantly less than those in the control group,and the differences were statistically significant.Adverse reactions occurred in all three groups.The D-dimer of the experimental group was(4.92±0.55)mg/L and(3.09±0.64)mg/L before and 7 days after surgery,respectively.The D-dimer of the control group was(4.67±0.31)mg/L and(3.87±0.64)mg/L before and 7 days after surgery,respectively.The differences were statistically significant(P BBB 00.05).No serious adverse reactions and complications occurred in both groups.CONCLUSIONS: The efficacy of Panax notoginseng combined with tranexamic acid in the treatment of hidden blood loss after PFNA in the elderly patients with intertrochanteric fracture is more obvious than that of tranexamic acid alone in the treatment of combined Chinese and Western medicine.Meanwhile,tranexamic acid has certain anticoagulant effect after surgery,and will not cause obvious adverse reactions.