气血双补法对老年患者半髋关节置换术后隐性失血的影响  

Effect of therapy for tonifying Qi and blood on hidden blood loss after hemiarthroplasty in elderly patients

作　　者：吴显兴 刘克莉 黄江华 吴国璟 牙爱萍 韦秀衣 WU Xianxing;LIU Keli;HUANG Jianghua;WU Guojing;YA Aiping;WEI Xiuyi(Baise Hospital of Traditional Chinese Medicine,Baise 533000,Guangxi,China)

机构地区：[1]百色市中医医院,广西百色533000

出　　处：《现代中西医结合杂志》2022年第17期2379-2382,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：百色市科技研究与技术开发计划课题(百科20193218)。

摘　　要：目的观察气血双补法对老年患者半髋关节置换术后隐性失血的影响。方法将2020年2月—2021年8月百色市中医医院收治的40例老年股骨颈骨折行半髋关节置换术患者随机分为治疗组及对照组各20例,对照组在术后予常规预防感染、消炎止痛、补液、预防血栓等治疗,治疗组在对照组治疗的基础上予八珍汤口服14 d。观察2组患者术前3 d及术后第3天、第7天的血细胞比容(HCT)、血红蛋白(Hb)水平,记录2组患者的术中失血量、术后引流量、输血量、总失血量、显性失血量、隐性失血量,评估2组患者术后第3天、第14天患肢疼痛模拟评分(VAS)及Harris髋关节功能评分。结果2组患者术前3 d的Hb及HCT比较差异均无统计学意义(P均>0.05);术后第3天,2组患者Hb及HCT均较术前明显降低(P均<0.05),且对照组Hb及HCT均明显低于治疗组(P均<0.05);术后第7天,2组患者Hb及HCT均较术后第3天明显升高(P均<0.05),且治疗组Hb及HCT均明显高于对照组(P均<0.05)。2组患者的术中失血量、术后引流量、输血量、显性失血量比较差异均无统计学意义(P均>0.05);治疗组的总失血量及隐性失血量均明显少于对照组(P均<0.05)。治疗组术后第3天及术后第14天VAS评分均明显低于对照组(P均<0.05),Harris髋关节功能评分均明显高于对照组(P均<0.05)。结论气血双补法可显著减少老年患者半髋关节置换术后的隐性失血,促进患者术后Hb、HCT的恢复,减轻患者术后疼痛,利于患者术后关节功能的恢复。Objective It is to observe the effect of therapy for tonifying Qi and blood on hidden blood loss after hemiarthroplasty in elderly patients.Methods Forty elderly patients with femoral neck fracture undergoing hemiarthroplasty in Baise Hospital of Traditional Chinese Medicine from February 2020 to August 2021 were randomly divided into the treatment group and the control group,with 20 cases in each group.The control group received routine treatment such as preventing infection,anti-inflammatory and analgesic,fluid infusion,preventing thrombosis and so on,the treatment group received Bazhen Decoction orally for 14 days on the basis of the treatment of the control group.The levels of hematocrit(HCT)and hemoglobin(Hb)of patients in the two groups were observed 3 days before operation,3 days and 7 days after operation,the intraoperative blood loss,postoperative drainage volume,blood transfusion volume,total blood loss,revealed blood loss,and hidden blood loss of patients in the two groups were recorded,and the scores of visual analogue scale(VAS)and Harris Hip Joint Function Scale of affected limbs of patients in the two groups were evaluated 3 days and 14 days after operation.Results There was no significant difference in Hb and HCT 3 days before operation between the two groups(P>0.05);on the third day after operation,Hb and HCT in the two groups were significantly lower than those before operation(all P<0.05),and Hb and HCT in the control group were significantly lower than those in the treatment group(all P<0.05);on the 7th day after operation,Hb and HCT in both groups were significantly higher than those on the 3rd day after operation(all P<0.05),and Hb and HCT in the treatment group were significantly higher than those in the control group(P<0.05).There was no significant difference in intraoperative blood loss,postoperative drainage volume,blood transfusion volume and revealed blood loss between the two groups(all P>0.05),the total blood loss and hidden blood loss in the treatment group were significantly less

关 键 词：气血双补 八珍汤 髋关节置换 隐性出血 

分 类 号：R687.4[医药卫生—骨科学]