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[1]展寶明,陳達,張慶文.桃紅四物湯預防全髖關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的臨床研究[J].中醫(yī)正骨,2014,26(09):25-28.
　ZHAN Baoming*,CHEN Da,ZHANG Qingwen..Clinical study of oral application of TAOHONG SIWU Decoction in preventing deep venous thrombosis after total hip arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(09):25-28.
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桃紅四物湯預防全髖關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的 臨床研究()
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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09期
頁碼:
25-28
欄目:
臨床研究
出版日期:
2014-09-30

文章信息/Info

Title:
Clinical study of oral application of TAOHONG SIWU Decoction in preventing deep venous thrombosis after total hip arthroplasty
作者:
展寶明1; 陳達2; 張慶文3
1.山東省萊蕪市人民醫(yī)院,山東 萊蕪 271100;
2.廣州中醫(yī)藥大學,廣東 廣州 510006;
3.廣州中醫(yī)藥大學第一附屬醫(yī)院,廣東 廣州 510405
Author(s):
ZHAN Baoming*; CHEN Da; ZHANG Qingwen.
*People's Hospital of Laiwu City,Laiwu 271100,Shandong,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 髖 靜脈血栓形成 手術(shù)后并發(fā)癥 桃紅四物湯
Keywords:
Arthroplasty; replacement; hip;  Venous thrombosis;  Postoperative complications;  TAOHONG SIWU decoction
摘要:
目的:探討桃紅四物湯預防全髖關(guān)節(jié)置換術(shù)后并發(fā)下肢深靜脈血栓形成的有效性及安全性。方法:初次行單側(cè)全髖關(guān)節(jié)置換術(shù)患者60例,隨機分為2組,每組30例。觀察組予以桃紅四物湯口服,對照組予以利伐沙班片口服,連續(xù)服用2周。觀察2組患者凝血指標、下肢深靜脈血栓形成情況及用藥安全情況。結(jié)果:手術(shù)前后不同時間點間活化部分凝血酶時間、凝血酶原時間及D-二聚體檢測結(jié)果比較,差異均有統(tǒng)計學意義,存在時間效應(yīng)(F=3.803,P=0.025; F=25.584,P=0.000; F=26.099,P=0.000); 2組間活化部分凝血酶時間、凝血酶原時間及D-二聚體檢測結(jié)果比較,差異均無統(tǒng)計學差異,不存在分組效應(yīng)(F=0.271,P=0.605; F=1.653,P=0.204; F=0.930,P=0.339); 時間因素與分組因素不存在交互效應(yīng)(F=2.312,P=0.104; F=0.528,P=0.591; F=0.351,P=0.694)。手術(shù)前后不同時間點間國際標準化比率檢測結(jié)果比較,差異無統(tǒng)計學意義,不存在時間效應(yīng)(F=3.814,P=0.052); 2組間國際標準化比率檢測結(jié)果比較,差異均無統(tǒng)計學差異,不存在分組效應(yīng)(F=0.006,P=0.936); 時間因素與分組因素不存在交互效應(yīng)(F=0.092,P=0.786)。觀察組并發(fā)深靜脈血栓形成3例,股靜脈2例,腘靜脈1例; 對照組并發(fā)深靜脈血栓形成2例,股靜脈1例,腘靜脈1例; 2組間深靜脈血栓形成發(fā)生率比較,差異無統(tǒng)計學意義(χ2=0.218,P=0.640)。2組間術(shù)中出血量、輸血量及術(shù)后引流量比較差異均無統(tǒng)計學意義[(449.33±87.74)mL,(455.76±76.88)mL; t=-0.302,P=0.764;(273.33±108.07)mL,(263.33±115.92)mL; t=0.346,P=0.731;(269.68±72.36)mL,(271.59±66.96)mL; t=-0.106,P=0.916]。手術(shù)前后不同時間點間血紅蛋白含量比較,差異有統(tǒng)計學意義,存在時間效應(yīng)(F=18.019,P=0.000); 2組間血紅蛋白含量比較,差異無統(tǒng)計學意義,不存在分組效應(yīng)(F=1.950,P=0.168); 時間因素與分組因素不存在交互效應(yīng)(F=0.343,P=0.710)。2組患者用藥期間均無消化道出血、皮膚黏膜出血及消化道不適等不良反應(yīng)發(fā)生,均未發(fā)生藥物過敏反應(yīng),肝、腎功能檢查無異常。結(jié)論:桃紅四物湯口服用于全髖關(guān)節(jié)置換術(shù)后深靜脈血栓形成的預防,有效性和安全性與口服利伐沙班片相當。
Abstract:
Objective:To observe the effectiveness and safety of oral application of TAOHONG SIWU decoction in preventing deep venous thrombosis(DVT)after total hip arthroplasty(THA).Methods:Sixty patients underwent unilateral THA were randomly divided into 2 groups,30 cases in each group.The patients in the treatment group were treated with oral application of TAOHONG SIWU decoction,while the others in control group were treated with Rivaroxaban orally.All patients in both groups were treated for 2 weeks.Then the coagulation indicators,DVT incidence and the safety indicators were observed.Results:There was statistical difference in APTT,PT and D-dimer level between different time points,in other words,there was time effect(F=3.803,P=0.025; F=25.584,P=0.000; F=26.099,P=0.000).There was no statistical difference in APTT,PT and D-dimer level between the 2 groups,in other words,there was no group effect(F=0.271,P=0.605; F=1.653,P=0.204; F=0.930,P=0.339).There was no interaction between time factor and grouping factor(F=2.312,P=0.104; F=0.528,P=0.591; F=0.351,P=0.694).There was no statistical difference in INR between different time points,in other words,there was no time effect(F=3.814,P=0.052).There was no statistical difference in INR between the 2 groups,in other words,there was no group effect(F=0.006,P=0.936).There was no interaction between time factor and grouping factor(F=0.092,P=0.786).DVT was found in 3 cases of treatment group,2 in femoral vein and one in popliteal vein.DVT was found in 2 cases of control group,one in femoral vein and one in popliteal vein.There was no statistical significance in the incidence of DVT between the 2 groups(χ2=0.218,P=0.640).There was no statistical difference in intraoperative blood loss,total blood transfusions and postoperative drainage between the two groups(449.33+/-87.74 vs 455.76+/-76.88 mL,t=-0.302,P=0.764; 273.33+/-108.07 vs 263.33+/-115.92 mL,t=0.346,P=0.731; 269.68+/-72.36 vs 271.59+/-66.96 mL,t=-0.106,P=0.916).There was statistical difference in HGB between different time points(F=18.019,P=0.000),in other words,there was time effect.There was no statistical difference in HGB between the 2 groups(F=1.950,P=0.168),in other words,there was no group effect.There was no interaction between time factor and grouping factor(F=0.343,P=0.710).No adverse effect was observed such as alimentary tract hemorrhage,skin and mucosa hemorrhage,alimentary tract indisposition,drug allergy,hepatic disfunction and renal disfunction in both groups.Conclusion:Oral application of TAOHONG SIWU decoction is similar to oral application of Rivaroxaban in effectiveness and safety in preventing DVT after THA.

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通訊作者:陳達 E-mail:[email protected]
更新日期/Last Update: 2014-09-30