云南白药胶囊对颈椎椎管减压术、锁骨骨折切开复位术围术期出血与创面愈合的影响  

Effects of Yunnan Baiyao Capsules on Perioperative Bleeding and Wound Healing in Cervical Spinal Decompression and Open Reduction of Clavicle Fractures

作　　者：杨林[1] 关宏业[1] 曾明[1] 杨健齐[1] 李世渊[1] 邝满源 李家颖 谭健韶[1] YANG Lin;GUAN Hong-ye;ZENG Ming;YANG Jian-qi;LI Shi-yuan;KUANG Man-yuan;LI Jia-ying;TAN Jian-shao(Department of Spine and Bone Surgery,Foshan First People's Hospital,Foshan Guangdong 528000)

机构地区：[1]佛山市第一人民医院脊柱骨外科,广东佛山528000

出　　处：《世界中西医结合杂志》2023年第1期109-113,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：佛山市科技创新项目(1920001001103)。

摘　　要：目的探讨云南白药胶囊在颈椎椎管减压术、锁骨骨折切开复位术围术期中的应用价值。方法选取2020年1月—2021年10月期间佛山市第一人民医院脊柱骨外科收治的120例颈椎椎管减压术、锁骨骨折切开复位术患者作为试验对象,采用随机数字表法分为对照组和治疗组,每组各60例。两组患者均按照原定手术方案接受手术,治疗组辅以云南白药胶囊治疗,对照组给予空白淀粉安慰剂,围术期(术前3 d起服至术后2 d)服用。观察比较两组患者围术期出血量、引流情况、手术相关并发症及不良反应情况、手术创面愈合情况及术前3 d、术后2 d血清生长因子[血管内皮生长因子(Vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(Basic fibroblast growth factor,bEGF)]水平变化。结果(1)治疗后治疗组单位出血量及总出血量均较对照组减少,差异有统计学意义(P<0.05)。(2)治疗后治疗组24、48 h引流量及总引流量均较对照组减少,差异有统计学意义(P<0.05),引流管引流时间与对照组比较,差异无统计学意义(P>0.05)。(3)治疗后治疗组并发症发生率1.67%(1/60)较对照组11.67%(7/60)降低,差异有统计学意义(P<0.05)。(4)治疗组手术创面愈合时间优于对照组,差异有统计学意义(P<0.05)。(5)术后2 d,治疗组血清VEGF、bEGF水平均较手术前3 d和对照组升高,差异有统计学意义(P<0.05)。(6)治疗期间,治疗组无不良反应情况。结论云南白药胶囊有利于减少颈椎椎管减压术与锁骨骨折切开复位术患者手术出血及围术期引流量,降低手术相关并发症发生率,安全性具有保障,且有助于促进手术创口早期愈合,可能与上调血清生长因子表达有关。Objective To explore the application value of Yunnan Baiyao capsules in the perioperative period of cervical spinal decompression and open reduction of clavicle fractures.Methods A total of 120 patients undergoing cervical spinal decompression and open reduction of clavicle fractures in the Department of Spine and Bone Surgery,Foshan First People′s Hospital from January 2020 to October 2021 were included in this study and assigned into a control group(n=60)and an observation group(n=60)according to the random number table.Both groups underwent surgery according to the original plan.The observation group was treated with Yunnan Baiyao capsules,and the control group with blank starch placebo during the perioperative period(from 3 days before operation to 2 days after operation).The perioperative bleeding volume and drainage volume,the incidence of surgery-related complications and adverse reactions,and surgical wound healing were compared between the two groups.Furthermore,the serum levels of growth factors including vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bEGF)were compared between 3 days before operation and 2 days after operation as well as between the two groups.Results(1)The bleeding volume per unit and total bleeding volume in the observation group were lower than those in the control group(P<0.05).(2)The drainage volume at the time points of 24 h and 48 h and the total drainage volume in the observation group were lower than those in the control group(P<0.05).The drainage time of the drainage tube showed no significant difference between the two groups(P>0.05).(3)The incidence of complications in the observation group was 1.67%(1/60),which was lower than that(11.67%,7/60)in the control group(P<0.05).(4)The healing time of surgical wound in the treatment group was shorter than that in the control group(P<0.05).(5)The serum levels of VEGF and bEGF in the observation group 2 days after operation elevated compared with those 3 days before operation and were higher than those

关 键 词：颈椎椎管减压术 锁骨骨折切开复位术 围术期出血 创面愈合 生长因子 

分 类 号：R274.1[医药卫生—中医骨伤科学]