加味归脾复元汤改善全膝关节置换术后隐性失血的效果观察  

Curative Observation of Modified Guipi Fuyuan Decoction on Improving Hidden Blood Loss after Total Knee Arthroplasty

作　　者：黄金[1] 赵良虎[1] 杨勇[1] HUANG Jin;ZHAO Lianghu;YANG Yong(Department of Knee Surgery,Panzhihua Integrated Traditional Chinese and Western Medicine Hospital,Panzhihua Sichuan 617000,China)

机构地区：[1]攀枝花市中西医结合医院膝关节外科,四川攀枝花617000

出　　处：《四川中医》2022年第3期134-137,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：G20工程医药产业创新研发专项(基金号:Z181100002214813)

摘　　要：目的:探析加味归脾复原汤治疗全膝关节置换术(TKA)术后隐性失血的应用效果。方法:选择2017年1月~2020年1月在本院骨科行TKA治疗的102例患者,依据随机单盲分组法分为对照组和研究组,每组51例。对照组术后接受常规西医治疗,研究组在此基础上给予加味归脾复原汤服用。比较两组总体失血情况、红细胞总数(RBC)、血红蛋白(Hb)、红细胞积压(Hct)、网织红细胞(Rtc)水平及并发症发生率,并使用美国膝关节协会(AKS)评分和视觉模拟(VAS)评分评估患者的膝关节功能、疼痛程度。结果:与对照组比较,研究组总失血量和隐形失血量较低,显性失血量较多(P<0.05);治疗后,两组RBC、Hb、Hct水平较治疗前明显升高,Rtc水平明显降低,且研究组治疗后RBC、Hb、Hct水平显著低于对照组,Rtc水平显著高于对照组(P<0.05);治疗后,两组AKS评分明显升高,VAS评分明显降低,且研究组治疗后AKS评分高于、VAS评分低于对照组(P<0.05);研究组术后并发症发生率显著低于对照组,有统计学差异(3.92%vs 17.65%,P<0.05)。结论:TKA术后应用加味归脾复原汤,不仅能有效减少患者术后隐形失血量、总失血量,改善RBC、Hb、Hct、Rtc水平,还能促进患者膝关节功能恢复,减轻疼痛,降低术后并发症发生率,有利于患者早期康复。Objective:To explore the curative effect of Modified Guipi Fuyuan Decoction on hidden blood loss after total knee arthroplasty(TKA).Methods:A total of 102 patients who underwent TKA in orthopedics department of the hospital from January 2017 to January 2020 were enrolled.They were divided into a controlled group and a study group by randomized single-blind grouping method,51 cases in each group.The controlled group was treated with routine western medicine,while the study group was treated with Modified Guipi Fuyuan Decoction on this basis.The overall blood loss,red blood cell count(RBC),hemoglobin(Hb),hematocrit(Hct),reticulocyte(Rtc)and the incidence of complications were compared between the two groups.The knee function and pain degree were evaluated by the scores of American knee society(AKS)and visual analogue scale(VAS).Results:Compared with the controlled group,overall blood loss and hidden blood loss were fewer,while apparent blood loss was more in study group(P<0.05).After treatment,levels of RBC,Hb and Hct were significantly increased,while Rtc was significantly decreased in both groups.After treatment,levels of RBC,Hb and Hct in the study group were significantly lower than those in the controlled group,while Rtc level was significantly higher than that in the controlled group(P<0.05).After treatment,AKS scores were significantly increased,while VAS scoreswere significantly decreased in both groups.After treatment,AKS scores in the study group were higher than those in the controlled group,while VAS scores were lower than those in the controlled group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than that in the controlled group(3.92%vs 17.65%,P<0.05).Conclusion:The application of Modified Guipi Fuyuan Decoction after TKA can not only effectively reduce postoperative hidden blood loss and overall blood loss,improve RBC,Hb,Hct and Rtc levels,but also promote the recovery of knee function,relieve pain and reduce incidence of postoperative complications,w

关 键 词：全膝关节置换术 加味归脾复原汤 隐性失血 关节功能 

分 类 号：R687.4[医药卫生—骨科学]