中医调理气血法经验方对人工全髋关节置换术围手术期隐性失血的影响  

Effects of TCM experience prescription of regulating Qi and blood on recessive blood loss in perioperative period of artificial total hip replacement

作　　者：沈茂荣[1] 熊智超 马东川 张辉宇 

机构地区：[1]广西中医药大学附属广西骨伤医院,广西南宁530012 [2]广西中医药大学,广西南宁530001

出　　处：《中医临床研究》2018年第3期145-148,共4页Clinical Journal Of Chinese Medicine

基　　金：广西科技基金科技攻关项目(桂科攻14124004-1-1)

摘　　要：目的:观察以中医"调理气血"法为指导组成的经验方对人工全髋关节置换术围手术期隐性失血的影响。方法:收集2014年1月-2017年12月的120例全髋关节置换(THA)患者(THA)采取电脑随机分组,将其分为试验组、对照组,其中试验组60例,术前3天开始服用经验方,1剂/d,对照组60例,术后使用利伐沙班10mg口服每天。观察两组手术前后血红蛋白(Hb)、红细胞压积(HCT),术中出血量、术后引流量。使用Gross方程,依据患者身高、体重和手术前后的红细胞压积(HCT),计算出患者的总失血量即失血总量=术前血容量(PBV)×(HCT术前-HCT术后),术前血容量(PBV)=K1×身高+K2×体重+K3,使用总失血量减去显性失血(术中出血量+术后引流量)即得隐性失血量。结果:血红蛋白及红细胞压积在术前3d:两组组间差异无统计学意义(P>0.05),不具有可比性,术前两组患者贫血情况不存在差异。术后,两组术中出血量差异无统计学意义(P>0.05)。两组患者在血红蛋白、红细胞压积、显性失血量、隐性失血量方面差异均具有统计学意义(P<0.05),试验组在降低血红蛋白及红细胞压积、减少隐性失血量及总失血量方面优于对照组。结论:本研究所用经验方能够通过调理气血,降低血红蛋白(Hb)及红细胞压积(Hct)下降程度,减少患者围手术期总失血量及隐性失血量,改善围手术期隐性失血状况,并且随着应用时间的延长效果逐渐显现。Objective:To observe the effect of TCM experience prescription of regulating Qi and blood on recessive blood loss in perioperative period of artificial total hip replacement.Methods:120cases of total hip replacement patients from January2014to December2017were divided into the experimental group and the control group by using computer random grouping,60cases in the experimental group received TCM experience prescription three days before surgery,one dose every day;60cases in the control group received postoperative Shaaban,10mg orally every day,Hb,HCT,the amount of bleeding during operation,postoperative drainage volume before and after the operation were observed;the Gross equation was applied and the height and weight of patients,HCT were used to calculate the total blood loss in patients.The total blood loss=PBV×HCT-HCT before surgery after surgery;PBV=K1×height+K2×weight+k3;recessive blood loss=the total blood loss-dominant blood loss.Results:Hemoglobin and hematocrit3days before operation:there was no significant difference between two groups(P>0.05),without comparability.There was no difference in anemia between two groups before operation.After operation,there was no significant difference in intraoperative blood loss between two groups(P>0.05).The differences of hemoglobin,hematocrit,dominant blood loss and recessive blood loss between two groups were statistically significant(P<0.05),and the experimental group was superior to the control group in reducing hemoglobin and hematocrit,reducing recessive blood loss and total loss of blood.Conclusion:TCM experience prescription could reduce conditioning blood,Hb and HCT,reduce the total blood loss and recessive blood loss during the perioperative period,improve perioperative recessive blood loss situation,and with the extension of application time;the effect was better.

关 键 词：调理气血法 全髋关节置换术 围手术期 隐性失血 

分 类 号：R619.1[医药卫生—外科学]