加味桃红四物汤联合利伐沙班防治髋、膝关节置换术后深静脉血栓形成临床研究  

Clinical Study on Modified Taohong Siwu Tang Combined with Rivaroxaban in Prevention and Treatment of Deep Vein Thrombosis After Hip and Knee Arthroplasty

作　　者：黄香妙 HUANG Xiangmiao

机构地区：[1]永康市第一人民医院骨二科,浙江永康321302

出　　处：《新中医》2022年第8期50-53,共4页New Chinese Medicine

摘　　要：目的:观察加味桃红四物汤联合利伐沙班防治髋、膝关节置换术后深静脉血栓形成(DVT)的临床疗效。方法:选取90例行髋、膝关节置换术患者,按随机数字表法分为对照组和观察组,每组45例。2组术后均给予抗感染、营养支持、镇痛及康复治疗,对照组术后在此基础上给予利伐沙班片治疗,观察组术后在对照组基础上给予加味桃红四物汤治疗。2组均治疗14 d。比较2组DVT及并发症发生率;比较2组治疗前后全血高切黏度、全血低切黏度、血浆黏度、D-二聚体(D-D)及纤维蛋白原(FIB)水平。结果:观察组DVT发生率6.67%,低于对照组24.44%(P<0.05)。术后7 d、14 d,2组全血高切黏度、全血低切黏度、血浆黏度、D-D及FIB水平均较术后1 d降低,观察组全血高切黏度、全血低切黏度、血浆黏度、D-D及FIB水平均低于同期对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率13.33%,低于对照组33.33%(P<0.05)。结论:加味桃红四物汤联合利伐沙班能有效防治髋、膝关节置换术后DVT,改善血液流变学,抑制血液凝集,降低并发症发生率。Objective: To observe the clinical effect of the therapy of modified Taohong Siwu tang combined with rivaroxaban on the prevention and treatment of deep vein thrombosis(DVT) after hip and knee arthroplasty. Methods:A total of 90 patients who received the hip and knee arthroplasty were selected and divided into the control group and the observation group according to the random number table method, with 45 cases in each group. Both groups were treated with antiinfection, nutritional support, analgesia and rehabilitation treatment after operation. The control group was additionally treated with rivaroxaban tablets after operation,and the observation group was additionally treated with modified Taohong Siwu tang based on the treatment of the control group. Both groups were treated for 14 days. The incidence of DVT and complications were compared between the two groups;before and after treatment,the levels of high-shear whole blood viscosity,low-shear whole blood viscosity,plasma viscosity,D-dimer(D-D) and fibrinogen(FIB) were compared between the two groups. Results:The incidence of DVT was 6.67% in the observation group,lower that of 24.44% in the control group(P<0.05). Seven and fourteen days after operation, the high-shear whole blood viscosity, low-shear whole blood viscosity,plasma viscosity,D-D and FIB levels in the two groups were decreased when compared with those one day after operation,and the above levels in the observation group were lower than those in the control group at the same period,differences being significant(P<0.05). The incidence of postoperative complications was 13.33% in the observation group,lower than that of 33.33% in the control group(P<0.05). Conclusion:The therapy of modified Taohong Siwu tang combined with rivaroxaban can effectively prevent and treat DVT after hip and knee arthroplasty,improve the hemorheology,inhibit the coagulation of blood,and reduce the incidence of postoperative complications.

关 键 词：髋关节置换术 膝关节置换术 深静脉血栓形成 桃红四物汤 利伐沙班 血液流变学 凝血 并发症 

分 类 号：R619.2[医药卫生—外科学]