摘要
目的探讨益气活血膏方联合氨甲环酸对全髋关节置换患者围手术期失血量、血液流变学以及凝血功能的影响。方法选取2019年7月—2021年4月广西中医药大学附属瑞康医院骨科收治的股骨颈骨折患者71例,按照治疗方式不同分为2组。治疗组37例在围手术期予以益气活血膏方联合氨甲环酸治疗,对照组34例单纯予以氨甲环酸治疗。检测2组患者术前1 d、术后第3天、术后第7天血红蛋白(Hb)、血细胞比容(HCT)、血液流变学指标及凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)],比较2组失血量及下肢深静脉血栓形成(DVT)情况。结果2组患者术后Hb及HCT水平均较术前明显降低,但在术后第7天时均呈上升趋势,且治疗组Hb、HCT水平明显高于对照组,差异均有统计学意义(P均<0.05);2组患者术后血液流变学指标及D-D水平均较术前降低,且治疗组各指标明显低于对照组,差异均有统计学意义(P均<0.05);2组患者术中出血量及输血量比较差异均无统计学意义(P均>0.05),但治疗组术后引流量明显少于对照组(P<0.05);2组患者显性失血量比较差异无统计学意义(P>0.05),而隐性失血量及总失血量治疗组均明显少于对照组(P均<0.05);术后第7天治疗组下肢DVT发生率为2.7%(1/37),明显低于对照组的14.7%(5/34),差异有统计学意义(P<0.05)。结论对需行全髋关节置换术的患者在围手术期给予益气活血膏方联合氨甲环酸治疗,能够提高患者术后Hb、HCT水平,可减少术后引流量、隐性失血量及总失血量,同时有利于改善术后血液流变学指标及凝血功能,减少双下肢DVT的发生。
Objective It is to investigate the effect of Yiqi Huoxue ointment combined with tranexamic acid on perioperative blood loss,hemorheology and coagulation function in patients treated with total hip replacement.Methods A total of 71 patients with femoral neck fractures who were admitted to the Department of Orthopedics,Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine from July 2019 to April 2021 were divided into 2 groups according to different treatment methods.37 cases in the treatment group were treated with Yiqi Huoxue ointment combined with tranexamic acid during the perioperative period,and 34 cases in the control group were treated with tranexamic acid alone.The levels of hemoglobin(Hb),hematocrit(HCT),blood rheology indexes and blood coagulation function[prothrombin time(PT),prothrombin time(PT),activate partial thromboplastin time(APTT),D-dimer(DD)]were detected at 1 day before operation,3rd day after operation,7th day after operation in the two groups,the blood loss and deep vein thrombosis(DVT)of the two groups were compared.Results The levels of Hb and HCT after surgery were significantly lower than those before surgery in the two groups,but both showed an upward trend on the 7th day after surgery,the Hb and HCT levels of the treatment group were significantly higher than those of the control group,and the differences were statistically significant(all P<0.05);the levels of hemorheological indexes and DD after surgery were lower than those before surgery in the two groups,and the indexes of the treatment group were significantly lower than those of the control group,the differences were statistically significant(all P<0.05).There was no statistically significant difference in the blood loss and blood transfusion between the two groups(all P>0.05),but the postoperative drainage volume of the treatment group was significantly less than that of the control group(P<0.05);there was no statistically significant difference in apparent blood loss between the two groups(P>0.05),while the hidden blood loss and total blood loss in the treatment group were significantly less than those in the control group(P<0.05).The incidence of DVT in the treatment group on the 7th day after surgery was 2.7%(1/37),which was significantly lower than 14.7%(5/34)of the control group(P<0.05).Conclusion The treatment of Yiqi Huoxue ointment combined with tranexamic acid in the perioperative period for patients requiring total hip replacement can increase the postoperative Hb and HCT levels,and reduce postoperative drainage,hidden blood loss and total blood loss,it is also beneficial to improve postoperative hemorheology and coagulation function,and reduce the occurrence of DVT in both lower limbs.
作者
李时斌
孟林
章晓云
LI Shibin;MENG Lin;ZHANG Xiaoyun(Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530000, Guangxi,China;Guangxi Orthopedics Hospital, Nanning 530000, Guangxi,China)
出处
《现代中西医结合杂志》
CAS
2022年第1期57-61,80,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
广西壮族自治区中医药局自筹经费科研课题(GZZC2019096)
全国中医药创新骨干人才培训项目(国中医药人教函[2019]128号)。
作者简介
李时斌,男,硕士,研究方向为骨与关节疾病及运动损伤;通信作者:孟林,E-mail:14262618@qq.com。
