摘要
目的研究益气活血饮联合规范预防人全膝关节置换术后下肢深静脉血栓形成的安全性及有效性。方法以79例初次行单侧人工全膝关节置换术(TKA)的患者为研究对象,随机分为对照组(n=43)和观察组(n=36),对照组按照指南规范的预防措施治疗,观察组则在规范预防的基础上加服中药复方益气活血饮,14 d后为疗效观察点。观察2组患者治疗期间患肢肿胀情况、凝血功能凝血酶原时间(PT)、活化部分凝血酶时间(APTT)变化情况及下肢深静脉血栓发生率、出血等并发症发生情况。结果 2组不同时间点的大小腿周径不全相同,比较显示术后第2天较术前增加(P <0. 05),且2组组间比较差异无统计学意义(P> 0. 05)。第7天及第14天2组周径较第2天缩小,且观察组小于对照组,差异有统计学意义(P <0. 05)。2组患者术后第2天患肢肿胀程度比较差异无统计学意义(P> 0. 05)。术后第7天及第14天时肿胀程度均较本组术后第2天时消退(P <0. 05),且观察组消退效果更佳明显(P <0. 05)。2组术前及术后第2天PT、APTT比较差异均有无统计学差异(P <0. 05)。组内比较显示,2组术后第7天及第14天PT及APTT均较本组治疗前及术后第2天延长(P <0. 05),且均在安全范围内。组间比较显示,术后第7天及第14天观察组能更显著的延长PT及APTT(P <0. 05)。DVT发生率比较差异有统计学意义(P <0. 05)。2组患者服药后均未发生呕血、咯血、黑便、便血等消化道出血症状,部分患者下肢局部皮肤黏膜有轻微瘀斑及出血点,但均属于术后正常表现,但观察组引流量少于对照组(P <0. 05)。结论益气活血饮联合规范预防人全膝关节置换术后下肢深静脉血栓形成的安全性、有效性。
Objective To investigate the safety and efficacy of Yiqihuoxue decoction in preventing the deep vein thrombosis of the lower extremities after total knee arthroplasty.Methods A total of 79 patients who underwent unilateral total knee arthroplasty(TKA)for the first time in our hospital were randomly divided into control group(n=43)and observation group(n=36).The patients in control group were treated according to the guidelines and preventive measures,however,the patients in observation group,on the basis of standard prevention and treatment,were treated by Yiqihuoxue decoction,with a treatment course of 14 days for both groups.The swelling condition of the affected limb during treatment,the changes of coagulation function PT and APTT and the incidence of deep venous thrombosis of the lower extremities,bleeding and other complications were observed and compared between the two groups.Results There was no significant difference in the circumferential diameter of the thigh and leg between the two groups(P>0.05).The circumferential diameter of the thigh and leg at 7d and 14d was shorter than that at 2d in both groups,moreover,which in observation group was significantly shorter than that in control group(P<0.05).There was no significant difference in the degree of swelling of the limbs at 2d after surgery between the two groups(P>0.05).The degree of swelling of the limbs at 7d and 14d after surgery was significantly relieved in each group,as compared with that at ad after surgery(P<0.05),moreover,which in observation group was more significant than that in control group(P<0.05).There were no significant differences in PT and APTT before and after surgery between the two groups(P>0.05).The PT and APTT were at 7d and 14d after surgery in each group were significantly lengthened,as compared with those before surgery and at 2d after surgery(P<0.05),moreover,the improvement degree in observation group was more significant than that in control group(P<0.05).There was significant difference in incidence of DVT between the two groups(P<0.05).There were no significant differences in adverse reactions after surgery between the two groups(P>0.05).However the draining volume in observation group was significantly less tha that in control group(P<0.05).Conclusion Yiqihuoxue decoction is effective and safe in preventing the deep vein thrombosis of lower extremities after total knee arthroplasty.
作者
刘泽
窦勃
韩光普
霍文颖
LIU Ze;DOU Bo;HAN Guangpu(Department of Osteology,Lulong County Hospital,Hebei,Lulong 066400,China)
出处
《河北医药》
CAS
2018年第22期3401-3405,共5页
Hebei Medical Journal
关键词
益气活血饮
膝关节置换
深静脉血栓
Yiqihuoxue decoction
knee replacement
deep vein thrombosis
