加减失笑七厘散联合低分子肝素钙预防THA术后DVT形成的疗效观察  

Observational Study of Modified Shixiao Qili Powder Combined with Low Molecular Weight Heparin Calcium in Preventing Deep Vein Thrombosis Formation after Total Hip Arthroplasty

作　　者：张霞 吴小莉 谭小花 冉建英 Zhang Xia;Wu Xiaoli;Tan Xiaohua;Ran Jianying(Chongqing Three Gorges Medical College,Chongqing 404000,China)

机构地区：[1]重庆三峡医药高等专科学校,重庆404000 [2]重庆三峡医药高等专科学校附属中医院,重庆404120

出　　处：《中国中医急症》2024年第10期1799-1803,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：重庆市教委科学技术研究青年项目(KJQN202102709)。

摘　　要：目的 观察加减失笑七厘散联合低分子肝素钙预防人工髋关节置换术(THA)后下肢深静脉血栓(DVT)形成的疗效。方法 选取90例老年股骨颈骨折行THA的患者,按随机数字表法分为A、B、C 3组,每组各30例。A组患者予加减失笑七厘散穴位贴敷联合皮下注射低分子肝素钙。B组患者予加减失笑七厘散汤剂内服联合皮下注射低分子肝素钙。C组患者单纯予以皮下注射低分子肝素钙。比较各组患者DVT发生率、患肢周径、疼痛、血浆D-二聚体,并观察各组患者术后伤口引流量、局部皮肤情况。结果 A组及B组术后DVT发生率低于C组,但差异无统计学意义(P> 0.05)。干预后,各组大小腿周径差均缩小,A组改善优于B、C组,但差异无统计学意义(P> 0.05)。干预后,血浆D-二聚体逐渐降低,术后1 d、术后3 d各组血浆D-二聚体比较,差异有统计学意义(P <0.05)。术后48 h切口引流量A组明显少于B组和C组,差异有统计学意义(P <0.05)。术后皮下瘀斑A组和B组均发生1例,C组发生3例,差异无统计学意义(P> 0.05)。采用数字评分表法进行术后疼痛评分,差异有统计学意义(P <0.05)。结论 相较于单纯低分子肝素钙治疗,髋关节置换术后患者采用低分子肝素钙联合加减失笑七厘散治疗,可降低DVT发生率,减轻皮肤淤血的发生、降低疼痛程度,且穴位贴敷组比口服汤剂组在减轻患肢肿胀、减少术后出血量方面有更优的疗效,安全性高。Objective:To observe the efficacy of modified Shixiao Qili powder combined with low molecular weight heparin calcium in preventing deep vein thrombosis(DVT)formation after total hip arthroplasty(THA).Methods:A total of 90 elderly patients with femoral neck fractures undergoing THA were selected and randomly divided into three groups A,B,and C,with 30 patients in each group.Group A received modified Shixiao Qili pow-der acupoint patch combined with subcutaneous injection of low molecular weight heparin calcium.Group B re-ceived modified Shixiao Qili powder oral decoction combined with subcutaneous injection of low molecular weight heparin calcium.Group C received only subcutaneous injection of low molecular weight heparin calcium.The inci-dence of DVT,circumference of affected limbs,pain,plasma D-dimer levels,postoperative wound drainage volume,and local skin conditions were compared among the three groups.Results:The postoperative DVT incidence in Groups A and B was lower than in Group C,but the difference was not statistically significant(P>0.05).After in-tervention,the difference in thigh and calf circumferences decreased in all three groups,with Group A showing bet-ter improvement than Groups B and C,although the difference was not statistically significant(P>0.05).Plasma D-dimer levels gradually decreased after intervention,and the comparison among the three groups on postoperative day 1 and day 3 showed statistical significance(P<0.05).The wound drainage volume within 48 hours postopera-tively was significantly lower in Group A compared with Groups B and C,with statistical significance(P<0.05).Subcutaneous ecchymosis occurred in one case in both Groups A and B,and in three cases in Group C,with no significant difference(P>0.05).Postoperative pain scores using the numerical rating scale showed statistical signif-icance(P<0.05).Conclusion:Compared with monotherapy with low molecular weight heparin calcium,the combi-nation with modified Shixiao Qili powder in THA patients can reduce the incidence of DVT,allevia

关 键 词：深静脉血栓 加减失笑七厘散 低分子肝素钙 髋关节置换术 穴位贴敷 

分 类 号：R687.4[医药卫生—骨科学]