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
张霞 1吴小莉 2谭小花 2冉建英2
作者信息
- 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
- 折叠
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.
Abstract
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,alleviate skin ecchy-mosis,and decrease pain levels.The acupoint patch group showed better efficacy than the oral decoction group in reducing swelling in the affected limb and decreasing postoperative bleeding volume,with high safety.
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Key words
DVT/Modified Shixiao Qili powder/Low molecular weight heparin calcium/Total hip arthroplasty/Acupoint patch引用本文复制引用
基金项目
重庆市教委科学技术研究青年项目(KJQN202102709)
出版年
2024
NETL
NSTL
万方数据