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[1]王平,盧啟貴,黃東紅,等.桃紅四妙湯結(jié)合低分子肝素鈣防治全膝關(guān)節(jié)置換術(shù)后深靜脈血栓形成的臨床觀察[J].中醫(yī)正骨,2012,24(01):27-31.
　WANG Ping*,LU Qi-gui,HUANG Dong-hong,et al.Clinical observation on the curative effect of TAOHONG SIMIAO DECOCTION combined with low molecular weight heparin calcium in the preventive treatment of deep vein thrombosis after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(01):27-31.
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桃紅四妙湯結(jié)合低分子肝素鈣防治全膝關(guān)節(jié)置換術(shù)后深靜脈 血栓形成的臨床觀察()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第24卷
期數(shù):
2012年01期
頁(yè)碼:
27-31
欄目:
臨床研究
出版日期:
2012-01-31

文章信息/Info

Title:
Clinical observation on the curative effect of TAOHONG SIMIAO DECOCTION combined with low molecular weight heparin calcium in the preventive treatment of deep vein thrombosis after total knee arthroplasty
作者:
王平; 盧啟貴; 黃東紅; 孫克民; 李政; 裴代平; 高迪; 徐展
廣東省深圳平樂骨傷科醫(yī)院,廣東 深圳 518010
Author(s):
WANG Ping*; LU Qi-gui; HUANG Dong-hong; SUN Ke-min; LI Zheng; PEI Dai-ping; GAO Di; XU Zhan.
*Shenzhen Pingle Orthopedic Hospital,Shenzhen 518010,Guangdong,China
關(guān)鍵詞:
靜脈血栓形成 關(guān)節(jié)成形術(shù); 置換; 膝 桃紅四妙湯 肝素; 低分子量 治療; 臨床研究性
Keywords:
Venous thrombosis;  Arthroplasty; replacement; knee;  TAOHONG SIMIAO DECOCTION;  Heparin; low-molecular-weight;  Therapies; investigational
摘要:
目的:探討桃紅四妙湯配合低分子肝素鈣防治全膝關(guān)節(jié)置換術(shù)后深靜脈血栓形成的臨床療效及安全性。方法:將符合要求的40例患者隨機(jī)分為治療組和對(duì)照組,每組20例。治療組采用桃紅四妙湯加低分子肝素鈣治療,對(duì)照組僅采用低分子肝素鈣治療。術(shù)后測(cè)定2組患者的患肢腫脹情況、凝血指標(biāo)、血小板計(jì)數(shù)、切口引流量、血腫瘀斑及深靜脈血栓發(fā)生情況。結(jié)果:①患肢腫脹情況。大腿周徑:不同時(shí)間點(diǎn)周徑不全相同(F=25.320,P=0.000); 2組間周徑總體有差別(F=5.530,P=0.024),進(jìn)一步比較顯示術(shù)后第6天治療組周徑小于對(duì)照組(F=175.303,P=0.000); 治療方法與時(shí)間因素之間存在交互作用(F=14.214,P=0.000)。小腿周徑:不同時(shí)間點(diǎn)周徑不全相同(F=67.520,P=0.000); 2組間周徑總體有差別(F=5.348,P=0.026),進(jìn)一步比較顯示術(shù)后第2天、第6天、第10天治療組周徑小于對(duì)照組(F=13.960,P=0.001; F=42.183,P=0.000; F=7.678,P=0.009); 治療方法與時(shí)間因素之間存在交互作用(F=22.428,P=0.000)。②凝血指標(biāo)。2組患者術(shù)后第2天凝血酶原時(shí)間及活化部分凝血活酶時(shí)間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(t=1.480,P=0.147; t=0.821,P=0.417); 治療組術(shù)后第14天與術(shù)后第2天凝血酶原時(shí)間及活化部分凝血活酶時(shí)間差值均大于對(duì)照組(t=2.117,P=0.041; t=2.104,P=0.042)。③血小板計(jì)數(shù)。不同時(shí)點(diǎn)血小板計(jì)數(shù)不全相同(F=67.155,P=0.000); 2組間血小板計(jì)數(shù)未見不同(F=0.716,P=0.403); 治療方法與時(shí)間因素之間不存在交互效應(yīng)(F=0.318,P=0.591)。④切口引流量。術(shù)后治療組切口引流量小于對(duì)照組(t=1.520,P=0.137)。⑤血腫瘀斑發(fā)生情況。術(shù)后2組患者血腫、瘀斑發(fā)生情況比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.244; χ2=2.667,P=0.102)。⑥深靜脈血栓發(fā)生情況。治療期間僅對(duì)照組2例發(fā)生深靜脈血栓,2組患者深靜脈血栓發(fā)生情況比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.244)。結(jié)論:桃紅四妙湯結(jié)合低分子肝素鈣能明顯延長(zhǎng)凝血酶原時(shí)間及活化部分凝血活酶時(shí)間,明顯減輕全膝關(guān)節(jié)置換術(shù)后患肢腫脹,減少術(shù)后出血,有效防治全膝關(guān)節(jié)置換術(shù)后深靜脈血栓形成,并且具有較高的安全性。
Abstract:
Objective:To explore the clinical curative effect and safety of TAOHONG SIMIAO DECOCTION combined with low molecular weight heparin calcium(LMWHC)in the preventive treatment of deep vein thrombosis(DVT)after total knee arthroplasty(TKA).Methods:Forty patients met the requirements were randomly divided into treatment group and control group,20 cases in each group.Patients in the treatment group were administrated with TAOHONG SIMIAO DECOCTION combined with LMWHC,while the others in the control group were administrated with LMWHC only.The swelling situations of the affected limbs,coagulation indexes,platelet count,incision drainage,hematoncus ecchymosis and DVT occurrences of the patients in the 2 groups were measured after TKA.Results:①The swelling situations of the affected limbs:On the aspect of thigh circumference:not all of the circumferences were same at the different time points(F=25.320,P=0.000); there was difference in circumference between the 2 groups totally(F=5.530,P=0.024),the circumference of treatment group was less than that of control group at the 6th day after TKA through the further comparison(F=175.303,P=0.000); there was an interaction between treatment method and time factor(F=14.214,P=0.000).On the aspect of calf circumference:not all of the circumferences were same at the different time points(F=67.520,P=0.000); there was difference in circumference between the 2 groups totally(F=5.348,P=0.026),the circumference of treatment group was less than that of control group at the 2nd,6th,10th day after TKA through the further comparison(F=13.960,P=0.001; F=42.183,P=0.000; F=7.678,P=0.009); there was an interaction between treatment method and time factor(F=22.428,P=0.000).②Coagulation indexes:There was no statistical difference in prothrombin time(PT)and activated partial thromboplastin time(APTT)between the 2 groups at the 2nd day after TKA(t=1.480,P=0.147; t=0.821,P=0.417); The difference in PT and APTT between the 14th postoperative day value and the 2nd postoperative day value of the treatment group were all larger than those of the control group(t=2.117,P=0.041; t=2.104,P=0.042).③Platelet count:not all of the platelet counts were same at the different time points(F=67.155,P=0.000); there was no difference in platelet count between the 2 groups(F=0.716,P=0.403); there was not an interaction between treatment method and time factor(F=0.318,P=0.591).④Incision drainage of treatment group was less than that of the control group after TKA(t=1.520,P=0.137).⑤There was no statistical difference in incidence of hematoncus and ecchymosis between the 2 groups(P=0.244; χ2=2.667,P=0.102).⑥D(zhuǎn)VT occurrences:Only 2 cases with DVT were found in the control group during the treatment period; there was no statistical difference in incidence of DVT between the 2 groups(P=0.244).Conclusion:The therapy of TAOHONG SIMIAO DECOCTION combined with LMWHC of higher safety can effectively prevent DVT through obviously extension of PT and APTT,obviously relieving of the affected limb swelling situations after TKA and reduction of postoperative bleeding.

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備注/Memo

備注/Memo:
基金項(xiàng)目:廣東省中醫(yī)藥局建設(shè)中醫(yī)藥強(qiáng)省科研資助基金(粵中醫(yī)藥局2009036)
更新日期/Last Update: 2012-01-20