加味八珍汤对全膝关节置换术后隐性失血的影响

发布时间：2018-01-23 14:35

  本文关键词： 加味八珍汤 人工全膝关节置换术 隐性失血　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:在中医药理论指导下,观察加味八珍汤对人工全膝关节置换(Total Knee Arthroplasty,TKA)术后隐性失血的影响,比较手术前后血红蛋白(HB)、红细胞比容(HCT),并观察术中出血量、术后引流量及膝下肿胀程度,计算隐性失血量,探讨加味八珍汤对减少全膝关节置换术后隐性失血的临床疗效,为防治全膝关节置换术后隐性失血提供有效的中医药治疗方法和客观的临床依据。方法:采用临床随机对照方法,选取2016年2月至2017年2月在广州中医药大学附属骨伤科医院住院治疗并符合纳入标准的病例共60例,按入院顺序依次编号,通过查随机数字表将患者分为观察组及对照组,每组各30例。对照组予术后常规对症治疗,观察组在对照组治疗基础上予加味八珍汤治疗。观察并记录两组患者术前、术后第1、3、7、10天红细胞比容(HCT)、血红蛋白(HB)的变化,比较术后两组患者的隐性失血量。所有数据使用SPSS 19.0软件进行统计分析。结果:1.两组患者术前红细胞比容(HCT)、血红蛋白(HB)、膝下肿胀程度比较,差异无统计学意义(P0.05)。2.两组患者术中出血量、术后48h引流量及显性失血量比较,差异无统计学意义(P0.05)。3.两组患者术后隐性失血量比较,观察组明显低于对照组,差异有统计学意义(P0.05)。4.两组患者手术后HCT、HB下降后上升,组间比较差异有统计学意义(P0.05);两组患者在术后第1天、第1-3天HCT、HB的减少值方面比较,差异无统计学意义(P0.05);在术后第3-7天、术后第7-10天HCT、HB的增加值方面比较,观察组均明显高于对照组,差异均有统计学意义(P0.05)。5.两组患者术后第1、3天HB比较,差异无统计学意义(P0.05);术后第7、10天HB比较,观察组均明显高于对照组,差异均有统计学意义(P0.05)。6.两组患者术后第3天、第7天、第10天膝下10cm肿胀程度比较,观察组均明显低于对照组,差异均有统计学意义(P0.05)。结论:加味八珍汤能够减少TKA患者术后的隐性失血量,随着服药时间的延长,能够减轻TKA患者术后膝下肿胀程度,提升TKA患者术后的HB。
[Abstract]:Objective: to observe the effect of modified Bazhen decoction on recessive blood loss after total Knee arthroplasty (TKA) under the guidance of traditional Chinese medicine (TCM). Before and after operation, the hemoglobin HBs and erythrocyte volume of HCT were compared. The amount of blood loss during operation, postoperative drainage volume and the degree of subknee swelling were observed, and the amount of recessive blood loss was calculated. To explore the clinical effect of modified Bazhen decoction on reducing recessive blood loss after total knee arthroplasty. To provide effective Chinese medicine treatment and objective clinical basis for prevention and treatment of recessive blood loss after total knee arthroplasty. Methods: clinical randomized control method was used. From February 2016 to February 2017, 60 patients who were hospitalized in the affiliated Orthopaedics and Trauma Hospital of Guangzhou University of traditional Chinese Medicine and met the inclusion criteria were selected and numbered according to the order of admission. The patients were divided into observation group and control group with 30 cases in each group. The patients in the observation group were treated with modified Bazhen decoction on the basis of the treatment of the control group. The changes of erythrocyte specific volume (HCT) and hemoglobin (HBB) in the two groups were observed and recorded before and after operation. The recessive blood loss was compared between the two groups after operation. All the data were analyzed by SPSS 19.0 software. Results the RBC volume of two groups was compared before operation. There was no significant difference in the degree of subknee swelling between the two groups. The volume of blood loss during operation, the drainage volume and the amount of dominant blood loss 48 hours after operation were compared between the two groups. There was no significant difference between the two groups. The amount of recessive blood loss in the two groups was significantly lower than that in the control group. The difference was statistically significant (P 0.05). The HB of HCT was decreased and then increased in the two groups, and the difference between the two groups was statistically significant (P 0.05). There was no significant difference between the two groups in the decrease of HCT HB on the 1st and 1-3 days after operation (P 0.05). The increase of HCT HB in the observation group was significantly higher than that in the control group on the 3-7 days and 7-10 days after operation. There was no significant difference in HB between the two groups on the 1st day after operation (P 0.05). The HB of the observation group was significantly higher than that of the control group on the 7th day after operation, and the difference was statistically significant (P0.05U. 6.) on the 3rd and 7th day after operation, the patients in the observation group were significantly higher than those in the control group. On the 10th day, the swelling degree of 10 cm below the knee in the observation group was significantly lower than that in the control group. Conclusion: the modified Bazhen decoction can reduce the recessive blood loss after TKA patients, with the prolongation of medication time. It can reduce the degree of subknee swelling in patients with TKA and enhance the postoperative HB in patients with TKA.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R274.9
，

本文编号：1457772