摘要
目的:观察十全大补汤联合蔗糖铁治疗全膝关节置换术围手术期贫血的临床疗效。方法:72例因膝骨关节炎接受单侧全膝关节置换术患者,按照随机数字表法平均分为治疗组和对照组。所有患者排除手术禁忌证后择期手术。对照组术后当天给予蔗糖铁注射液治疗,治疗组在对照组的基础上联合十全大补汤治疗。比较两组患者临床疗效、血象、血清炎症相关指标及异体输血率、并发症发生率、美国特种外科医院膝关节评分(hospital for specialsurgery knee score,HSS)和疼痛视觉模拟量表评分(vsual analogue scale,VAS)。结果:治疗组有效率91.7%(33/36),高于对照组的72.2%(26/36),差异具有统计学意义(P<0.05);两组治疗后第7天、第14天的血红蛋白(hemoglobin,HGB)、红细胞(red blood cell,RBC)、红细胞比容(hematocrit,HCT)、血小板(platelet,PLT)水平均升高,与对照组比较,治疗组HGB、RBC、HCT水平显著升高(P<0.05),但两组PLT水平比较,差异无统计学意义(P>0.05);治疗组白细胞介素-6(interleukin-6,IL-6)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)水平显著低于对照组(P<0.05);治疗组HSS评分显著高于对照组(P<0.05),VAS评分显著低于对照组(P<0.05);治疗组围手术期异体输血率显著低于对照组(P<0.05);治疗组并发症发生率显著低于对照组(P<0.05)。结论:十全大补汤联合蔗糖铁能显著改善全膝关节置换术患者围手术期贫血,提高血象水平,减轻炎症反应,降低并发症发生率及异体输血率,提高临床疗效。
Objective:To observe the clinical efficacy of Shiquan Dabu Decoction combined with iron sucrose in the treatment of perioperative anemia after total knee arthroplasty.Methods:A total of 72 patients who underwent unilateral total knee arthroplasty for knee osteoarthritis were divided into treatment group and control group according to the random number table method.All patients underwent elective surgery after excluding contraindications to surgery.The control group was treated with iron sucrose injection on the day after surgery,and the treatment group was treated with Shiquan Dabu Decoction based on that of the control group.The clinical efficacy,blood image,serum inflammation-related indexes,allogeneic transfusion rate,complication rate,hospital for special surgery knee score(HSS)and pain visual analogue scale(VAS)were compared between the two groups.Results:The effective rate of the treatment group was 91.7%(33/36),which was significantly higher than that of the control group 72.2%(26/36),and the difference was statistically significant(P<0.05).Compared with that of the control group,the levels of HGB,RBC and HCT in the treatment group were significantly increased(P<0.05),but there was no significant difference in the levels of PLT between the two groups(P>0.05).The levels of protein and CRP were significantly lower than those in the control group(P<0.05),the HSS score in the treatment group was significantly higher than that in the control group(P<0.05),the VAS score was significantly lower than that in the control group(P<0.05),the perioperative allogeneic blood transfusion rate in the treatment group was significantly lower than that in the control group(P<0.05),and the complication rate in the treatment group was significantly lower than that in the control group(P<0.05).Conclusion:Shiquan Dabu Decoction combined with iron sucrose can significantly improve perioperative anemia,improve blood level,reduce inflammatory response,reduce the incidence of complications and allogeneic blood transfusion in patients undergoing total knee arthroplasty,and improve clinical efficacy.
作者
陈洋洋
艾进伟
杨军
齐秀春
张子硕
CHEN Yangyang;AI Jinwei;YANG Jun;QI Xiuchun;ZHANG Zishuo(College of Orthopaedics and Traumatology,Henan University of Chinese Medicine,Zhengzhou Henan China 450046;The Second Affiliated Hospital to Henan University of Chinese Medicine/Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou Henan China 450002)
出处
《中医学报》
CAS
2024年第5期1098-1103,共6页
Acta Chinese Medicine
基金
2021年河南省专业学位研究生精品教学案例项目(YJS2021AL062)
2023年河南中医药大学研究生教育教学改革研究与实践项目(YJSJ2023-044)。
关键词
全膝关节置换术
围手术期贫血
十全大补汤
蔗糖铁
炎性因子
total knee arthroplasty
perioperative anemia
Shiquan Dabu Decoction
iron sucrose
inflammatory factor
作者简介
陈洋洋(1995-),男,河南周口人,硕士研究生,研究方向:中医药防治骨科疾病;通信作者:艾进伟(1973-),男,河南汝阳人,医学博士,主任医师,硕士研究生导师。E-mail:ajw73@163.com。
