| Objective: Through the clinical observation of Houxueling applied in the perioperative period of the old age’s hip fracture to prevent the lower extremity’s deep vein thrombosis(DVT) to analysis the clinical curative effect and safety of using Houxueling to prevent DVT after the elderly hip fracture surgery. To find an optimal solution to prevent the lower limb of DVT after the hip fracture operation, reducing the incidence of lower limb DVT after elderly hip surgery as far as possible and the amount of low molecular heparin calcium and side effects, improving the life quality of patients.Methods: The 60 cases of elderly patients selected with hip fracture(between 60 to 90 years)(femoral neck fracture and intertrochanteric fracture) were divided into three groups randomly. Group A: low molecular heparin calcium; Group B: Houxueling plus low dose of low molecular heparin group; Group C: Houxueling group. 20 patients were chosen in each group and the drug treatment for 13 days, three days of preoperative and 10 days of postoperative respectively, without surgery. In addition to this, Group A was given low molecular heparin 4100 u subcutaneous injection 1 time each day. Group B gived oral huoxueling, one dose a day, morning and evening hours service, 100 ml each time except the use of low molecular heparin 2000 u subcutaneous injection; Group C only gived the huoxueling, one dose a day, morningandevening hours service, 100 ml each time.The patients were admitted to hospital to have routine preoperative examination including blood routine, the five items of blood clotting, color doppler ultrasound of lower limbs and others, and reviewed the blood routine and D- dimer, FIB index in postoperative 1, 2, 7, 14 days, and recorded intraoperative blood loss, postoperative week flow, total amount of blood transfusion, pain score index, etc. To review the color doppler ultrasound of lower limbs to check if the patients’ lower limb formed the DVT after the operation.Results:1)Through the R×C table chi-square analysis, it explained that comparability among three groups of gender, age, illness, disease and operation data sample; After the test of single factor variance, three groups of preoperative had comparability in D- dimer, FIB, platelet, hemoglobin, and limb weeks size comparison difference having no statistical significance(P > 0.05).2)The blood transfusion amount among the three groups has no statistical significance. But from the average figure in the amount of visible blood transfusion: low calcium group > low calcium and huoxueling group > huoxueling group.3)Through the one way analysis of variance, three sets of data meet normal distribution and homogeneity of variance. The intraoperative blood loss F = 0.59, P = 0.56 > 0.05, so the intraoperative blood loss among the three groups have no statistical significance. But it is visible that from the average figure in the bleeding amount: low calcium group > low calcium and huoxueling group > huoxueling group. The amount of post operation drainage F = 3.84, P = 0.03 < 0.05, so the differences exist the amount of post operation drainage had statistical significance about the three groups. Two comparison, it will be find that group A with B and C difference have statistically significant; There was no statistically significant difference between the two groups of B and C; it is visible from the mean figure amount of post operation drainage: low calcium group > low calcium and huoxueling group >huoxueling group.4)Three groups of hemoglobin data meet normal distribution and Homogenity of variances. Repeated data of variance analysis showed the data of the three groups at different time points are different, there are interaction effects between time and grouping. Postoperative day 1, 2, group B and group A, there were no statistically significant difference between group C, there is significant difference between group A and group C; Postoperative days 1, 2, the difference between group A and group B and C group were statistically significant, there is significant difference between group B and C groups; According to the average figure, it is visible in the late postoperative 7,14 days of group B, group C hemoglobin is higher in group A.5) Three sets of D- dimmer data meet normal distribution and homogeneity test of variances. The repeated data of variance analysis results show that the role of time factor among the three groups on different group was the same and there was no statistically significant difference. There was no statistically significant among three groups of D- dimmer differences at the same time, but the D- dimmer mean value is lower after 7 days and 14 days of group B than in group A and group C from the mean visibly.6)Three sets of FIB data meet normal distribution and homogeneity test of variances. The repeated data of variance analysis results show that the role of time factor among the three groups on different group was the same and there was no statistically significant difference. There was no statistically significant in the FIB difference among three groups at the same time point, but it was visible after 14 days in group B than in group A and group C, FIB mean value is low from the mean.7)Three sets of pain score data meet normal distribution and homogeneity test of variances. The repeated data of variance analysis results show that the role of time factor among the three groups on different group was the same and there was no statistically significant difference. In addition to the first day of group A compared with group C, P < 0.05, group A and group B, group B compared with group C, P > 0.05 which showed that there was no statistically significant difference. Group B compared with group C of P > 0.05 in 2, 7, 14 goes against days, it shows that there was no statistically significant difference between the two groups. Group A and group B, group A compared with group C P < 0.05 which suggested that there was significant difference between the two groups. It is visible that the average figure from group B and C group pain score lower than group A at the same time. To sum up, the BC in the two groups in postoperative pain relief in patients with 1, 2 days faster than group A.8)Three sets of lower extremity deep vein thrombosis data meet normal distribution and homogeneity test of variances. The single factor analysis of variance results show that the lower extremity deep vein thrombosis difference between three groups have no statistical significance.Conclusion: the curative effect of low molecular heparin and huoxueling to Ddimmer and FIB indicators is significant and huoxueling can significantly reduce the blood loss, postoperative flow and alleviate pain score, and can improve patients of Hemoglobin data index. It can obtain a preferable role in prevention of lower limb DVT with the huoxueling for elderly patients in orthopaedic postoperative, and huoxueling combined with low dose molecular heparin calcium can increase the effect even more. |
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