灸按膝六穴预防膝关节置换患者围手术期急性下肢DVT的效果  

Effects of moxibustion on six acupoints around the knee on prevention of perioperative acute deep venous thrombosis of the lower extremity in patients undergoing total knee arthroplasty

作　　者：冯银珍 黄素珍[1] 廖荣宗[1] 潘耀成 冯月景[2] 冯春韶 Feng Yirizhen;Huang Suzhen;Liao Rongzong;Pan Yaocheng;Feng Yuejing;Feng Churishao(Anesthesiology Operating Room,Foshan Hospital of Traditional Chinese Medicine,Guangdong Province,Foshan 528200,China;Department of Osteoarthritis,Foshan Hospital of Traditional Chinese Medicine,Guangdong Province,Foshan 528200、China;Second Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine,Guangdong Province,Foshan 528200,China)

机构地区：[1]广东省佛山市中医院麻醉科手术室,528200 [2]广东省佛山市中医院骨关节科,528200 [3]广东省佛山市中医院骨二科,528200

出　　处：《中华现代护理杂志》2020年第36期5080-5085,共6页Chinese Journal of Modern Nursing

基　　金：佛山市医学科研项目(20180088)。

摘　　要：目的:探讨灸按膝六穴法对膝关节置换患者围手术期下肢DVT的预防作用。方法:采用便利抽样法,选取2018年1月—2019年10月于广东省佛山市中医院行单膝膝关节置换术的80例患者为研究对象,按随机数字表法分为对照组和观察组各40例,对照组给予低分子肝素钙皮下注射等常规治疗和护理,观察组在对照组基础上给予灸按膝六穴方法。两组各观察14 d,比较两组小腿周径差(术前,术后第1、7、14天)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体等指标变化,术后第14天行下肢静脉超声检测有无DVT形成,并评价患者满意度。结果:两组组内术肢小腿周径差术后第1天与术前比较,差异有统计学意义(P<0.05),术后第7、14天与术后第1天比较,差异有统计学意义(P<0.05);两组组间术前、术后第1天术肢小腿周径差比较,差异无统计学意义(P>0.05),两组术后第7、14天比较,差异有统计意义(P<0.05)。两组组内术后第1天与术前PT、APTT、D-二聚体组内比较,差异均有统计学意义(P<0.05),术后第7、14天与术后第1天比较,差异均有统计学意义(P<0.05);两组组间术前和术后第1、7天PT、APTT、D-二聚体比较,差异均无统计学意义(P>0.05),术后第14天两组PT、APTT、D-二聚体比较,差异均有统计学意义(P<0.05)。对照组患者发生DVT 6例(15.0%),观察组患者无DVT发生;观察组总满意率高于对照组,差异均有统计学意义(P<0.05)。结论:灸按膝六穴能够减轻术后下肢肿胀,改善凝血功能,预防DVT发生,患者满意度较高。Objective To explore the preventive effect of moxibustion on six acupoints around the knee on perioperative deep venous thrombosis(DVT)of the lower extremity in patients undergoing total knee arthroplasty.Methods Using the convenient sampling method,a total of 80 patients who underwent single total knee arthroplasty in Foshan Hospital of Traditional Chinese Medicine in Guangdong Province from January 2018 to October 2019 were selected as the research objects.According to the random number table method,they were divided into the control group and the observation group with 40 cases in each group.The control group was given conventional treatments and nursing such as subcutaneous injection of low molecular weight heparin calcium and the observation group was given moxibustion on six acupoints around the knee on the basis of the control group.Patients in the two groups were observed for 14 days.Changes in circumference difference of calf(before operation,1,7,14 days after operation),plasma prothrombin time(PT),activated partial thromboplastin time(APTT)and D-dimer were compared between two groups.DVT formation was compared between the two groups on the 14th day after surgery and satisfaction of patients was evaluated.Results The differences in calf circuniferenee of the operating limbs within each group were statistically significant on the first day after operation and before operation(P<0.05).There were statistically significant differences between the 7th and 14th day after operation and the first day after operation(P<0.05).There was no statistically significant difference in calf circumference difference between the two groups before and on the first day after the operation(P>0.05).The differences between the two groups on the 7th and 14th day after operation were statistically significant(P<0.05).There were statistically significant differences in PT,APTT and D-dimer on the first day after surgery and before surgery within each group(P<0.05),and there were statistically significant differences between the 7th

关 键 词：关节成形术 置换 膝 深静脉血栓形成 膝六穴 满意度 疗效 中医护理 

分 类 号：R248.2[医药卫生—中医临床基础]