摘要
目的:探讨电针穴位刺激对髋关节置换术后深静脉血栓(DVT)形成的预防效果及部分治疗机理。方法:将180例髋关节置换术后患者随机分为对照组、针刺组和电针组,每组60人。对照组:基础治疗;针刺组:基础治疗联合针刺疗法;电针组:基础治疗联合电针疗法。观察手术前后的血栓弹力图(TEG)变化、下肢深静脉血流情况、疼痛视觉模拟评分(VAS)、患者开始下地活动时间等。结果:术后7天深静脉血栓(DVT)发生率对照组为30.0%,针刺组为21.7%,电针组为18.3%。针刺组、电针组与对照组比较,差异均有统计学意义(P<0.05);针刺组与电针组比较,差异无统计学意义(P>0.05)。VAS镇痛评分术后48小时与术后6、24小时3组组内比较,差异均有统计学意义(P<0.05)。术后48小时,针刺组、电针组与对照组比较,差异均有统计学意义(P<0.05)。针刺组与电针组比较,差异无统计学意义(P>0.05)。TEG显示与术前比较3组术后R时间显著缩短,CI延长,MA及α角增大。与对照组比较,针刺组、电针组术后第1天各项指标没有显著差异,但在术后第3天多项指标提示针刺组高凝指标有所减低,并在术后第7天组间比较有统计学差异(P<0.05)。结论:术后针刺及电针穴位刺激能降低髋关节置换术后DVT发生率,更有利于患者的康复。
Objective: To discuss the effects of transcutaneous electrical acupoint stimulation(TEAS) in the prevention of deep venous thrombosis(DVT) after total hip replacement(THR), and partial therapeutic mechanism.Methods: All 180 patients undergoing THR were randomized into the control group, the acupuncture group and electrical acupoints group, 60 cases each group. The control group: basic therapy;the acupuncture group: basic therapy combined with acupuncture therapy;electrical acupoint group: basic therapy combined with electrical acupoint therapy. To observe the changes of thrombelastogram(TEG), deep venous blood flow in lower limbs, VAS and off-bed time of the patients before and after the surgery. Results: DVT incidence in seven days after the operations in the control group was 30.0%, these of the acupuncture group and electrical acupoints group were 21.7% and 18.3%, the difference could be found when the acupuncture group and electrical acupoints group were compared with the control group(P<0.05);the difference had no statistical meaning when the acupuncture group was compared with electrical acupoint group(P>0.05). The difference was statistically significant when VAS scores in 48 hours after the surgery were compared with these in six hours and 24 ours after the operation among three groups(P<0.05). The difference was significant in 48 hours after the surgery when the acupuncture group and electrical acupoints group were compared with the control group(P<0.05). The difference had no statistical meaning when the acupuncture group was compared with electrical acupoints group(P >0.05). TEG demonstrated that compared with before surgery, R period after the surgery in three groups shortened significantly, CI prolonged, MA and α angle increased.Compared with the control group, no significant difference could be found in different indexes at the first day after the surgery in the acupuncture group and electrical acupoints group, but at the third day after the surgery, many indexes showed that hypercoagulability indexes in the acupuncture group lowered, the significant difference could be found at the seventh day after the surgery between both groups(P<0.05). Conclusion: Postoperative acupuncture and TEAS could reduce DVT incidence after THR, and they are beneficial to the recovery of the patients.
作者
张凌云
张国欣
王东红
梁曦
邱连利
金钰钧
戴刚
柳海平
薛建军
ZHANG Lingyun;ZHANG Guoxin;WANG Donghong;LIANG Xi;QIU Lianli;JIN Yujun;DAI Gang;LIU Haiping;XUE Jianjun(Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China;Gansu University of Chinese Medicine)
出处
《西部中医药》
2019年第8期104-107,共4页
Western Journal of Traditional Chinese Medicine
基金
甘肃省科技支撑计划项目(编号1504FKCA062)
