中西医结合治疗全膝关节置换术后深静脉血栓  

Treatment of deep venous thrombosis after total knee replacement with integrated traditional Chinese and western medicine

作　　者：尚延春 申晟 刘云龙 柴巍巍 SHANG Yanchun;SHEN Cheng;LIU Yunlong;CHAI Weiwei(Luoyang Orthopedic and Traumatology Hospital, Luoyang 450000, Henan Province, Chin)

机构地区：[1]洛阳正骨医院河南省骨科医院,河南洛阳450000

出　　处：《吉林中医药》2018年第5期549-552,共4页Jilin Journal of Chinese Medicine

基　　金：河南省中医管理局资助课题(2016ZY2088)

摘　　要：目的分析术后抗凝并活血补气中药内服在人工全膝关节置换术中的应用效果。方法选取全膝关节置换术患者80例,将所有患者随机分为观察组和对照组,每组各40例。术后观察组患者服用健脾活血补气类中药结合利伐沙班治疗,对照组患者单纯使用利伐沙班治疗,2组疗程均为10 d。对比分析2组术中失血量、术后伤口引流量和显性失血量,对比分析2组术前、术后3 d、术后10 d的血红蛋白水平、血小板水平、部分活化凝血酶原时间和凝血酶原时间及术后深静脉血栓的发生情况。结果术后3 d和术后10 d,观察组的APTT值明显高于对照组(P<0.05)。术后3 d时观察组PT值和血小板计数与对照组相比差异无统计学意义(P>0.05)。术后10 d时观察组PT值和血小板计数与对照组相比差异无统计学意义(P>0.05)。术后3 d和术后10 d,观察组血红蛋白明显高于对照组(P<0.05)。观察组的失血总量和显性失血量明显低于对照组(P<0.05)。术后2组患肢疼痛、Homans征阳性、股三角压痛等症状明显减轻,未见明显不良反应。术后4例发生DVT,发生率为5%。其中对照组发生3例,观察组发生1例,差异无统计学意义(P>0.05)。结论术后抗凝并活血补气中药内服在人工全膝关节置换术中能够有效预防术后DVT的形成,减少术后出血量。Objective To investigate and analyze the effect of Anticoagulation and Huoxue Buqi traditional Chinese medicine on total knee arthroplasty. Methods 80 patients with total knee arthroplasty were randomly divided into observation group and control group, 40 cases in each group, postoperative observation group patients was taken Jianpi Huoxue Buqi herbs combined with the rivaroxaban for treatment, control group was treated with rivaroxaban, two groups were treated for 10 days. The intraoperative blood loss, postoperative wound drainage and dominant blood loss were compared between the two groups. The hemoglobin levels, platelet levels, partial activated prothrombin time and prothrombin time were compared between the two groups preoperatively, 3 days, and 10 days after surgery. The incidence of deep vein thrombosis in two groups was compared and analyzed. Results The 3 day after operation and 10 days after operation, the APTT value of the observation group was higher than that of the control group（P〈 0.05）. At 3 days after operation, the PT value and platelet count of the observation group were not statistically significant compared with the control group（P 〉0.05）. At 10 days after operation, the PT value and platelet count of the observation group were not statistically significant compared with the control group（P 〉0.05）. After 3 days and 10 days after operation, the hemoglobin of the observation group was higher than that of the control group（P〈 0.05）. The total blood loss and dominant blood loss in the observation group were significantly lower than those in the control group（P〈 0.05）. The pain of the affected limb, the positive Humans sign and the tenderness of the femoral triangle were obviously relieved in the two groups after operation, and there was no obvious adverse reaction. A total of 4 patients developed DVT, and the incidence was 5%. There were 3 cases in the control group, and 1 cases in the observation group, the difference was not statistically significant（P 〉0.05�

关 键 词：深静脉血栓 全膝关节置换术 利伐沙班 活血补气 八珍汤 

分 类 号：I19[文学—世界文学]