益气活血法预防全膝关节表面置换术后下肢深静脉血栓的临床研究

发布时间：2018-03-03 12:25

本文选题：益气活血汤　切入点：血栓通注射液　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：通过观察益气活血法预防全膝关节表面置换术后下肢深静脉血栓形成的临床疗效,以更好的探讨中医药防治下肢深静脉血栓的作用机制,为中医药防治全膝关节表面置换术后下肢深静脉血栓提供循证医学支持。方法：根据病例纳入标准及病例排除标准,于2015年1月至2016年1月共收集60例患者,随机分为试验组30例(口服益气活血汤联合静滴血栓通注射液)和30例对照组(口服立伐沙班)。符合研究标准的患者术后均采用相同的基本预防措施,由同一组医生完成手术,均行单侧膝关节表面置换术,进行临床观察研究。结果：1、术后第一天,凝血酶原时间、D-二聚体较术前具有统计学意义(P0.01)。2、术后第3天红细胞计数、红细胞压积、血红蛋白浓度、纤维蛋白原、活化部分凝血酶时间、凝血酶时间较术前具有统计学意义(P0.01或P0.05)。3、术后第10天红细胞计数、血红蛋白、血小板及大腿肿胀率两组组间结果有统计学意义(P0.05),说明试验组优于对照组；4、两组患者术后第10天通过下肢静脉彩超证实均无深静脉血栓发现,且两组组间比较无显著差异(P0.05)。结论：口服益气活血汤联合静滴血栓通注射液不仅可以有效改善全膝关节表面置换术后血液的粘稠度,延长凝血时间,有效减低术后下肢深静脉血栓的发生率；而且可以减少术后出血,减轻大腿肿胀率,降低贫血发生率。综上所述,该法具有疗效明确、价格低廉、患者接受度高、安全性好等特点,值的临床大力推广。
[Abstract]:Objective: to observe the clinical effect of supplementing qi and activating blood circulation method to prevent deep vein thrombosis of lower extremity after total knee arthroplasty, and to explore the mechanism of prevention and treatment of deep vein thrombosis of lower extremity by traditional Chinese medicine. To provide evidence-based medical support for the prevention and treatment of deep venous thrombosis of lower extremity after total knee arthroplasty with traditional Chinese medicine. Methods: from January 2015 to January 2016, 60 patients were collected according to the criteria of case inclusion and exclusion. They were randomly divided into trial group (30 cases) (oral Yiqi Huoxue decoction combined with intravenous drip of Xueshuantong injection) and control group (30 cases of control group). Patients who met the standard of study were treated with the same basic preventive measures after operation, and were operated by the same group of doctors. Results on the first day after operation, prothrombin time of D-dimer was significantly higher than that of pre-operation (P 0.01), erythrocyte count, hematocrit and hemoglobin concentration on the 3rd day after operation. Fibrinogen, activated partial thrombin time, thrombin time were significantly higher than those before operation (P0.01 or P0.05). The results of platelet and thigh swelling rates between the two groups were statistically significant, which indicated that the experimental group was superior to the control group (P 0.05). On the 10th day after operation, no deep venous thrombosis was found in both groups. There was no significant difference between the two groups (P 0.05). Conclusion: oral Yiqi Huoxue decoction combined with intravenous drip of Xueshuantong injection can not only effectively improve the viscosity of blood after total knee joint surface replacement, but also prolong the coagulation time. It can effectively reduce the incidence of postoperative deep venous thrombosis of lower extremities, and can reduce postoperative bleeding, reduce the rate of thigh swelling, and reduce the incidence of anemia. Good safety and other characteristics, value of the clinical vigorously promote.
【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】：2016
【分类号】：R274.9

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