益气活血法预防老年患者髋部术后下肢深静脉血栓形成  

Chinese drugs for supplementing qi and activating blood circulation(益气活血药)in preventing thrombosis in deep veins of lower limb after hip surgery in senile patients

作　　者：刘军[1] 万豫尧[1] 许树柴[1] 蔡德珺[1] 王慧敏[1] 吕燃[1] 李晓初[1] 刘岩[1] 严大波[1] 

机构地区：[1]广州中医药大学附属广东省中医院骨科,广东广州510120

出　　处：《中国骨伤》2006年第6期344-347,共4页China Journal of Orthopaedics and Traumatology

基　　金：广东省中医药管理局资助项目(编号:2002A101061)

摘　　要：目的:探讨益气活血法预防老年患者髋部术后下肢深静脉血栓形成(DVT)的效果及安全性。方法:将102例60～85岁髋部手术患者随机分为两组,其中预防组52例,男25例,女27例,年龄(70.55±6.73)岁。术前3d至术后7d每天静脉滴注参麦注射液加丹参注射液;对照组共50例,男22例,女28例,年龄(69.63±5.84)岁。术前12h,术后12、24h至术后第7天,皮下注射低分子肝素(LMWH)。两组均常规应用抗感染、维持水电解质、酸碱平衡等基础治疗。比较两组DVT发生率、出血情况、血红蛋白(HGB)含量、血小板(PLT)计数、凝血酶原时间(PT)、部分凝血酶原时间(APTT)、纤维蛋白原(FIB)含量变化,出现并发症和用药不良反应等情况来综合评定两组的防治效果。结果:两组术后DVT发生率为6.90%(7/102),其中预防组7.69%(4/52),对照组6.00%(3/50),两组发生率差异无显著性意义(P>0.05)。两组术前HGB含量、术中出血量、输血量均无统计学差异(P>0.05)。对照组术后引流量多于预防组,而预防组术后血红蛋白含量的回升较快(P<0.05)。两组PT术后均延长(P>0.05),而APTT无变化(P>0.05)。FIB含量术前与术后各时点相比,预防组无变化(P>0.05),而对照组有所减少(P<0.05)。预防组术后并发症少于对照组(P<0.05)。结论:两组均能有效预防老年髋部手术患者DVT的发生,不良反应与并发症益气活血组少于抗凝组。Objective：To evaluate the efficacy and safety of Chinese drugs for supplementing qi and activating blood circulation（益气活血药） in preventing thrombosis in deep veins of lower limb after hip surgery in senile patients. Methods：One hundred and two patients （ranging in age from 60 to 85 years）who were treated with hip surgery were divided into two groups randomly： preventing group （Group A, 52 patients ）and control group（ Group B,50 patients）. In Group A,25 patients were male and 27 patients were female,and mean age was 70. 55 ＋ 6. 73 years. The patients in Group A were given intravenously Shenmai injection（参麦注射液）in dose of 40 ml and Danshen injection（丹参注射液） 20 ml every day from the 3rd day before surgery to the 7th day after surgery. In Group B,22 patients were male and 28 patients were female, and mean age was 69. 63 ± 5.84 years. The patients in Group B were subcutaneously injected low molecular weight heparin （LMWH） at different times of 12th hour before operation, 12th and 24 th hour after operation, and 7th day after surgery. The routinely basic treatment were adopted in the two groups, including anti -infection and maintenance of electrolyte and acid-base balances. The parameters, such as the incidence of DVT, bleeding condition,the content of HGB, PLT count, PT and AP＇Iq＇, the content of FIB, incidences of complications and side effects of the patients in the two groups, were evaluated respectively. Results： DVT was found in 7 patients in the two groups （7/102, the incidence was 6.90% ）, including 4 patients in Group A （ 4/52, the incidence was 7.69% ） and 3 patients in Group B（3/50,the incidence was 6. 00% ）. The incidence of DVT had no significant difference in the two parameters between two groups （ P 〉 0. 05 ）. The content of HGB, bleeding during the operation and infusion amount also had no significant difference between the two groups（P 〉 0. 05 ）. The mean draining liquid of the patients in Group B was much hi

关 键 词：髋 手术后并发症 下肢 血栓形成 静脉 中药疗法 

分 类 号：R543.6[医药卫生—心血管疾病] R734[医药卫生—内科学]