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[1]張曉強,高菲菲,王戰(zhàn)朝,等.膝傷活血靈口服配合低分子肝素鈣皮下注射對全膝關(guān)節(jié)置換術(shù)后隱性失血的影響[J].中醫(yī)正骨,2014,26(04):23-25.
　Zhang Xiaoqiang*,Gao Feifei,Wang Zhanchao,et al.Effect of oral application of XISHANGHUOXUELING decoction combined with subcutaneous injection of low-molecular-weight heparin on hidden blood loss after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(04):23-25.
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膝傷活血靈口服配合低分子肝素鈣皮下注射對全膝關(guān)節(jié)置換 術(shù)后隱性失血的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年04期
頁碼:
23-25
欄目:
臨床研究
出版日期:
2014-04-30

文章信息/Info

Title:
Effect of oral application of XISHANGHUOXUELING decoction combined with subcutaneous injection of low-molecular-weight heparin on hidden blood loss after total knee arthroplasty
作者:
張曉強; 高菲菲; 王戰(zhàn)朝; 尚延春; 孟慶陽
河南省洛陽正骨醫(yī)院,河南 洛陽 471002
Author(s):
Zhang Xiaoqiang*; Gao Feifei; Wang Zhanchao; Shang Yanchun; Meng Qingyang.*
Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China
關(guān)鍵詞:
靜脈血栓形成 關(guān)節(jié)成形術(shù); 置換; 膝 手術(shù)后并發(fā)癥 出血 骨關(guān)節(jié)炎;  膝 中藥療法 肝素; 低分子量
Keywords:
Venous thrombosis;  Arthroplasty; replacement; knee;  Postoperative complications;  Hemorrhage;  Osteoarthritis; knee;  Drug therapy(TCD);  Heparin; low-molecular-weight
摘要:
目的:探討膝傷活血靈口服配合低分子肝素鈣皮下注射對全膝關(guān)節(jié)置換術(shù)后隱性失血的影響。方法:初次行單側(cè)全膝關(guān)節(jié)置換術(shù)的膝骨關(guān)節(jié)炎患者117例,隨機分為2組,觀察組59例,術(shù)后應(yīng)用膝傷活血靈口服配合低分子肝素鈣皮下注射抗凝; 對照組58例,單純應(yīng)用低分子肝素鈣抗凝。觀察2組患者術(shù)后下肢深靜脈血栓形成的發(fā)生情況及膝關(guān)節(jié)功能恢復(fù)情況,記錄2組患者失血量并進行比較。結(jié)果:術(shù)后第8天,2組患者間顯性失血量比較,差異無統(tǒng)計學意義[(447.89±138.67)mL,(456.00±132.03)mL; t=1.665,P=0.099]; 但觀察組失血總量、隱性失血量均少于對照組,差異有統(tǒng)計學意義[(804.34±222.06)mL,(1 103.34±261.87)mL; t=4.665,P=0.033;(401.89±98.67)mL,(566.00±102.03)mL; t=4.871,P=0.026]。2組患者切口均甲級愈合; 均無下肢深靜脈血栓形成。觀察組術(shù)后血紅蛋白含量低于80 g·L-14例,對照組術(shù)后血紅蛋白含量低于80 g·L-119例,輸入同型濃縮紅細胞4個單位后,血紅蛋白含量均恢復(fù)到正常參考值范圍內(nèi); 2組患者術(shù)后輸血例數(shù)比較,差異有統(tǒng)計學意義(χ2=12.498,P=0.000)。2組患者均獲隨訪,隨訪時間6～11個月,中位數(shù)8個月; 膝關(guān)節(jié)功能均恢復(fù)。結(jié)論:應(yīng)用膝傷活血靈口服配合低分子肝素鈣皮下注射預(yù)防全膝關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成,療效滿意; 且與單純應(yīng)用低分子肝素鈣相比,可減少患者術(shù)后隱性失血。
Abstract:
Objective:To explore the effect of oral application of XISHANGHUOXUELING decoction combined with subcutaneous injection of low-molecular-weight heparin(LMWH)on hidden blood loss after total knee arthroplasty(TKA).Methods:One hundred and seventeen patients with knee osteoarthritis were treated with unilateral TKA for the first time and then they were randomly divided into 2 groups,59 cases in observation group,while 58 cases in control group.Patients in the observation group were treated with oral application of XISHANGHUOXUELING decoction combined with subcutaneous injection of LMWH for anticoagulation after TKA,while the others in the control group were treated with monotherapy of subcutaneous injection of LMWH for anticoagulation.Then the postoperative deep venous thrombosis(DVT)in lower limbs and knee function restoration were observed,and the blood loss volume were recorded and compared between the 2 groups.Results:There was no statistical differences in the dominant blood loss volume between the 2 groups on the 8th day after TKA(447.89+/-138.67 vs 456.00+/-132.03 mL; t=1.665,P=0.099); while the total blood loss volume and hidden blood loss volume in the observation group were less than those of control group respectively(804.34+/-222.06 vs 1 103.34+/-261.87 mL; t=4.665,P=0.033; 401.89+/-98.67 vs 566.00+/-102.03 mL; t=4.871,P=0.026).All of the patients in the 2 groups got primary healing in the operative incisions and no DVT were found.The postoperative hemoglobin content were lower than 80 g/L in 4 patients(observation group)and 19 patients(control group)and were restored to normal range after the patients received 4 units concentrated red blood cells(CRBC)with same blood-type.There was statistical differences in the number of blood transfusion cases after TKA between the 2 groups(χ2=12.498,P=0.000).All patients in the 2 groups were followed up for 6-11 months with a median of 8 months,and the knee function were restored in all patients.Conclusion:The therapy of oral application of XISHANGHUOXUELING decoction combined with subcutaneous injection of LMWH has satisfactory preventative effects on DVT in lower limbs after TKA,and it is better than the monotherapy of subcutaneous injection of LMWH in reducing the postoperative hidden blood loss.

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更新日期/Last Update: 1900-01-01