中药预防下肢静脉曲张微创治疗术后并发症的临床研究

发布时间：2018-04-02 06:29

  本文选题：下肢静脉曲张　切入点：中药　出处：《北京中医药大学》2017年硕士论文

【摘要】：目的:全面的观察中药对小腿部大隐静脉曲张微创治疗术后疼痛、皮下瘀血、血栓性静脉炎、隐神经损伤、色素沉着等并发症的预防性作用。方法:选择2016年1月-12月单纯大隐静脉曲张患者134例,随机分为中药治疗组(a、b组)和对照组(c、d组)。4组病例大腿段均行大隐静脉曲张高位结扎+大腿段主干剥脱,中药治疗组围手术期口服中药(自拟方),对照组不服用中药,中药a组(35例)和对照c组(33例)小腿部行泡沫硬化剂(1%聚多卡醇)注射治疗;中药b组(34例)和对照d组(32例)小腿部行腔内激光灼闭术;四组术后予弹力绷带加压包扎3天,后改用医用弹力袜3个月。术后3天、1周、1个月、3个月随访。比较分析中药组与对照组组间,四组之间术后疼痛、皮下瘀血、深静脉血栓形成、症状性肺栓塞、血栓性静脉炎、隐神经损伤、色素沉着、过敏性皮炎、皮肤灼伤等并发症的情况。结果1.中药组与对照组术后并发症比较1.1术后疼痛中药组术后疼痛优于对照组,P≈0.0000.05,差异有统计学意义。1.2中药组血栓性浅静脉炎、色素沉着、皮下瘀血优于对照组,P0.05,差异有统计学意义;深静脉血栓形成、皮肤灼伤等并发症,中药组发病例数少于对照组,但无统计学差异。2.亚组之间术后并发症比较2.1术后疼痛中药a组优于中药b组,中药b组优于对照c组,对照c组优于对照d组,P0.05,有统计学意义。2.2深静脉血栓形成仅对照d组出现1例深静脉血栓形成患者,与其余三组比较,P0.05,无统计学差异。2.3血栓性浅静脉炎中药a组优于中药b组和对照c、d组,对照c组和优于对照d组,P0.05,有统计学差异。2.4色素沉着中药b组和对照d组色素沉着并发症均优于中药a组和对照c组,中药a组优于对照c组,P0.05,有统计学差异。2.5隐神经损伤中药a组隐神经损伤优于中药b组和对照d组;对照c组隐神经损伤优于中药b组和对照d组,P0.05,有统计学差异。2.6皮下瘀血中药a组皮下瘀血并发症均优于中药b组和对照d组,对照c组和中药b组均优于对照d组,P0.05,有统计学差异。2.7皮肤灼伤中药a组和对照c组未现皮肤灼伤,均优于对照d组,P0.05,有统计学差异。结论1.中药组术后疼痛、血栓性浅静脉炎、色素沉着、皮下瘀血优于对照组,P0.05,有统计学差异;深静脉血栓形成、皮肤灼伤等并发症例数少于对照组,但无统计学差异。2.中药+泡沫硬化剂注射治疗组(中药a组)术后并发症最少,优于其他三个亚组,差异有统计学意义。3.泡沫硬化剂注射治疗与激光灼闭术治疗相比,术后血栓性浅静脉炎、隐神经损伤、皮下瘀血、皮肤灼伤等并发症更少、更轻。
[Abstract]:Objective: to observe the effect of traditional Chinese medicine on the minimally invasive treatment of great saphenous vein varicose vein in the leg after operation, such as pain, subcutaneous blood stasis, thrombotic phlebitis and saphenous nerve injury. Methods: 134 patients with varicose great saphenous vein from January to December 2016 were selected. They were randomly divided into two groups: the Chinese medicine treatment group (group B) and the control group (group B). The thigh segment of the patients in the control group was treated with varicose varicose great saphenous vein ligation of the thigh segment at high position. The Chinese medicine was taken orally in the Chinese medicine treatment group during the perioperative period (self-prescription, the control group did not take Chinese medicine). Group A (n = 35) and control group C (n = 33) were treated by injection of foam-sclerosing agent (1% polybutanol), group B (n = 34) and control group (n = 32) were treated with intracavitary laser cauterization. The four groups were followed-up with elastic bandages for 3 days, and then with medical elastic socks for 3 months. The patients were followed up for 1 week, 1 month and 3 months after operation. The postoperative pain and blood stasis were compared between the traditional Chinese medicine group and the control group. Deep venous thrombosis, symptomatic pulmonary embolism, thrombotic phlebitis, saphenous nerve injury, pigmentation, allergic dermatitis, Results 1.Compared with the control group, the postoperative pain in the traditional Chinese medicine group was better than that in the control group (P 鈮，

本文编号：1699155