Clinical Investigation And Detection Of Prethrombotic State And Prevetion Of VTE With Blood-activating Herbs In Older Patients With Hip Fracture

BackgroundVTE is one of the major diseases that damage severely human health, which includes DVT and PE. there is no report on prediction of VTE and clinical evaluation of activating blood and resolving stasis herbs on the treatment of VTEObjectivesTo investigate the abnormal laboratory tests of the old patients with hip fracture, visualize the value of the laboratory tests and wells score in perioperative hip fracture, and evaluate the clinical effect of Preventing and treating VTE with blood-activating herbs.MethodsPatient:2010 April-December, in-patients the observed group (old patients with hip fracture):78 cases including 29 males and 49 females mean age 78.9±7.6 y (63-92 y). The control group:lower extremity fracture patients 28 casesincluding 16 males and 12 femalesmean age 48.3±3.6 y (41-56 y). The laboratory tests (FDP Fib D-dimer PC AT-ⅢGMP-140 and vWF) and Wells scores were assessed on admission day, and the statistical analysis was conducted using a Mann-whitney Test and Multiple Linear Regression; Besides, the observed group were then subdivided into 3 groups, according to the different treatment (Breviscapine,Low molecular weight heparin calcium,combined Low molecular weight heparin calcium and Breviscapine). The assessment (laboratory tests and Wells scores) were tested on 1th postoperative day and 7th postoperative day including ultrasonography test of the lower limbs. The results were analyzed by statistics SPSS 17.0 software package.ResultsThe laboratory tests (FDP Fib D-dimer PC AT-ⅢGMP-140 and vWF)of the observed group (old patients with hip fracture) were significantly abnormal and there is significant difference between the two groups. The regression equations could be built between Wells score and the D-dimer in the observed groupand Y=1.341 0.00008908D-D. The laboratory tests, including D-D,GMP-140 and vWF, were abnormal on 7th postoperative day。There were no significant differences of the laboratory tests among the three subgroup using different anticoagulant therapy.ConclusionPerioperative old patients with hip fracture was in prethrombotic state of DVT. Perioperative Wells scores and D-dimer assessment could be used to forecast DVT. Patients, with both middle or high group Wells score and positive D-D test, should be avoid to use activating blood and resolving stasis herbs only in anticoagulant therapy. And integrated TCM and WM anticoagulant therapy may increase the rate of complication,such as hemorrhage and so on.