| Objective:Using HuoXueHuaYu Decoction to intervene early intertrochanteric fracture,through the coagulation functionn and blood stasis scoring and hidden blood loss assessment HuoXueHuaYu Decoction in the early intertrochanteric fracture in application of efficacy and safety,thus for clinical further prevention and treatment of early intertrochanteric fracture deep vein thrombosis to provide efficient data base.Methods:67 patients eligible for inclusion and exclusion criteria were selected and randomly divided into 2 groups(33 in the experimental group and 34 in the control group).The control group started subcutaneous injection of low molecular weight heparin sodium from the first discontinued low-molecular-weight heparin sodium 12 hours before surgery,using a regular anticoagulation regimen(low molecular weight heparin sodium 1500u qd).In addition to the routine use of anticoagulant therapy in the experimental group,the other daily taking HuoXueHuaYu Decoction(HuoXueZhenTong Decoction)from the first day after admission to 12 hours before surgery.Blood samples were taken from the time of admission to the morning of the first,third,and fifth day before surgery,then detect coagulation function(PT,APTT,TT,Fib),D-dimer,the index of thromboelastography,hematocrit,hemoglobin,blood stasis syndrome score and calculate the amount of hidden blood loss according to the change of the Hematocrit value in the patient according to the Gross equation.EXCEL software was used to collect the data,and then the results were analyzed by statistical software SPSS 20.0.Results:A total of 67 patients were included in the study and the clinical data were collected,the experimental group(n=33)and the control group(n=34).After statistical analysis,there was no significant difference in gender,age,height,weight and BMI between the two groups of patients(P>0.05).The two groups of data were comparable.1.coagulation contrast:At three points in time,comparison in groups:The coagulation indexes of PT,APTT,TT and FIB in experimental group and control group were slightly improved on the third day after admission compared with the first day after admission,but the difference was not statistically significant(P>0.05),The indexes of PT,APTT,TT,FIB on the first day after admission were all improved on the fifth day after admission,with statistical significance(P<0.05).Comparison between groups:There was no significant difference between the experimental group and the control group on the first day after admission(P>0.05);on the third day after admission,the mean value of coagulation in the experimental group and the control group was basically the same,the difference was not statistically significant(P>0.05);on the fifth day after admission,the experimental group had better effects on the four items of coagulation than the control group(P<0.05),and the difference was statistically significant.2.D-dimer content:At three points in time,comparison in groups:The content of D-dimer in both groups was lower on the third day after admission than on the first day after admission,and was lower on the fifth day after admission than on the third day after admission.The difference was statistically significant(P<0.05).Comparison between groups:At the three time points,there was no significant difference between the first and third days after admission(P>0.05).On the fifth day after admission,the content of D-dimer in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).3.Thromboelastogram parameters:At three points in time,comparison in groups:The coagulation reaction time(R)and agglutination time(K)of the experimental group and the control group on the third day after admission were higher than those on the first day after admission,the solidification angle(a angle)and the maximal amplitude of thrombosis(MA)decreased,but the difference was not statistically significant(P>0.05).However,on the fifth day after admission,all parameters of the two groups were significantly different from those on the first day after admission(P<0.05).Comparison between groups:There was no significant difference between the experimental group and the control group on the first day after admission(P>0.05).On the 3rd day after admission,the influence of the experimental group and the control group on the parameters of the thrombelastograph was similar,and the difference was not statistically significant(P>0.05).The influence of thromboelastogram parameters on the experimental group was better than that of the control group on the fifth day after admission,and the difference was statistically significant(P<0.05).4.Blood stasis score:At three points in time,comparison in groups:The blood stasis score in the experimental group were basically the same on the third day after admission(19.79±3.08)and on the first day after admission(20.76±3.59),and the difference was not statistically significant(P<0.05).The blood stasis score in the experimental group were lower than the first day after admission(20.76±3.59)on the fifth day after admission(16.97±2.21),and the difference was statistically significant(P<0.05);The mean value of blood stasis score in the control group was the same on the third day(20.15±2.93)and the fifth day(19.21±2.06)after admission,and on the first day after admission(20.76±2.51),and the difference was not statistically significant(P>0.05).Comparison between groups,at three points in time:There was no significant difference between the two groups after admission on the first and third days(P>0.05).On the fifth day after admission,the score of blood stasis in the experimental group(16.97±2.21)were lower than those in the control group(19.21±2.06),the difference was statistically significant(P<0.05).5.Hemoglobin content:At three points in time,comparison in groups:The hemoglobin content in both groups were lower than the first day after admission on the third day after admission(P<0.05);there was no significant difference between the fifth day after admission and the third day after admission(P<0.05).Comparison between groups:There was no significant difference in hemoglobin between the two groups on the first day after admission,the third day after admission,and the fifth day after admission(P>0.05).6.Hematocrit:At three points in time,comparison in groups:The hematocrit of both groups was lower than the first day after admission on the third day after admission(P<0.05);there was no significant difference between the fifth day after admission and the third day after admission(P>0.05).Comparison between groups:There was no significant difference in the hematocrit between the two groups on the first day after admission,the third day after admission,and the fifth day after admission(P>0.05).7.The influence of HuoXueHuaYu Decoction on the hidden blood loss:On the third day after admission,the average amount of hidden blood loss in the control group was(246.40±25.29)ml,and the average amount of hidden blood loss in the experimental group was(255.09±20.05)ml.There was no significant difference between the two groups(P>0.05).On the fifth day after admission,the average amount of hidden blood loss was(260.43±30.27)ml in the control group,and(278.62±43.93)ml in the experimental group.There was no significant difference between the two groups(P>0.05).Conclusion:Application of HuoXueHuaYu Decoction with low-molecular-weight heparin sodium in patients in early intertrochanteric fracture can effectively improve the coagulation and prevent deep vein thrombosis,without increasing the risk of hidden blood loss,with good safety and effectiveness. |
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