伤科黄水联合骨一方预防股骨粗隆间骨折早期深静脉血栓的临床观察  

Clinical Observation on Shangke Huangshui Medicated Gauze Combined with Guyi Decoction in Preventing the Incidence of DVT in Early Femoral Intertrochanteric Fracture

作　　者：沈钊雄[1] 吴峰[1] 冯周莲 Shen Zhaoxiong;Wu Feng;Feng Zhoulian(The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine,Guangdong,Foshan 528000,China)

机构地区：[1]广州中医药大学第八临床医学院,广东省佛山市中医院,广东佛山528000

出　　处：《中国中医急症》2024年第7期1229-1232,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省中医药局中医药科研项目(20221381);广东省佛山市卫生健康局医学科研项目(20220443)。

摘　　要：目的观察加速康复外科理念(ERAS)指导下伤科黄水外敷联合骨一方内服预防股骨粗隆间骨折(FIF)早期深静脉血栓(DVT)的临床效果。方法将120例FIF患者随机分为治疗组与对照组各60例。对照组采用ERAS方案治疗,治疗组在对照组基础上使用伤科黄水外敷及骨一方内服。对比两组入院第1、3、7天D-二聚体(D-D)、血红蛋白(HGB)、红细胞沉降率(ESR)、C反应蛋白(CRP)及全血还原黏度高、低切(ηbrH、ηbrL)、血浆黏度(ηp);第2、7天查血管超声对比DVT发生率。结果基线资料及入院后第1天D-D、HGB、ESR、CRP、ηbrH、ηbrL、ηp差异均无统计学意义(P>0.05)。两组D-D、ESR、CRP、ηbrH、ηbrL、ηp含量均随时间延长呈先升高后降低的趋势。入院后第3、7天,治疗组低于对照组(P<0.05)。治疗组DVT发生率为3.33%(2例),低于对照组的13.33%(8例)(P<0.05)。结论基于ERAS理念,伤科黄水外敷联合骨一方内服能减轻FIF患者炎症反应、降低凝血及纤溶活性、改善血流瘀滞,降低DVT发生率。Objective:To observe the clinical effect of Shangke Huangshui Medicated Gauze combined with Guyi Decoction for preventing deep vein thrombosis(DVT)in early femoral intertrochanteric fracture(FIF)patients based on the concept of enhanced recovery after surgery(ERAS).Methods:A total of 120 FIF patients were ran⁃domly divided into two groups,with 60 cases in each group.The control group was treated with a conventional ERAS regimen.On the basis of the control group,the treatment group was given Shangke Huangshui Medicated Gauze for external application combined with Guyi Decoction for oral administration.Serum D-dimer(D-D),hemo⁃globin(HGB),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and hemorheological(ηbrH,ηbrL,ηp)levels were examined in both groups on day 1,3 and 7,while the lower limb blood vessel ultrasonography was measured on day 2 and 7.Results:The differences between baseline data and day 1′s D-D,HGB,ESR,CRP,ηbrH,ηbrL,andηp levels were not statistically significant(P>0.05).The contents of D-D,ESR,CRP,ηbrH,ηbrL,andηp in both groups showed a tendency to increase and then decrease with time(P<0.05).On days 3 and 7,the treatment group was less than the control group,and the differences were all statistically significant(P<0.05).The incidence of DVT in the treatment group(2 cases,3.33%)was less than that in the control group(8 cases,13.33%)(P<0.05).Conclusion:Based on the concept of ERAS,the Shangke Huangshui Medicated Gauze combined with Guyi Decoction can reduce inflammatory response,decrease coagulation and fibrinolytic activity,im⁃prove blood stasis,and reduce the incidence of DVT in patients with FIF.

关 键 词：股骨粗隆间骨折 深静脉血栓 加速康复外科 伤科黄水 骨一方 

分 类 号：R364.15[医药卫生—病理学]