84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]劉飛,劉剛,郭浩山,等.化瘀滲濕湯對(duì)全膝關(guān)節(jié)置換術(shù)后血漿D-二聚體 和纖維蛋白原含量的影響[J].中醫(yī)正骨,2016,28(03):30-33.
　LIU Fei,LIU Gang,GUO Haoshan,et al.Effect of Huayu Shenshi Tang(化瘀滲濕湯)on plasma contents of D-dimer and fibrinogen after total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(03):30-33.
點(diǎn)擊復(fù)制

化瘀滲濕湯對(duì)全膝關(guān)節(jié)置換術(shù)后血漿D-二聚體 和纖維蛋白原含量的影響()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年03期
頁(yè)碼:
30-33
欄目:
臨床研究
出版日期:
2016-03-20

文章信息/Info

Title:
Effect of Huayu Shenshi Tang(化瘀滲濕湯)on plasma contents of D-dimer and fibrinogen after total knee arthroplasty
作者:
劉飛; 劉剛; 郭浩山; 劉曉之; 鄭大偉; 安龍; 徐金華; 王東偉; 范憲輝; 路聊東
山東省聊城市中醫(yī)醫(yī)院,山東 聊城 252000
Author(s):
LIU Fei; LIU Gang; GUO Haoshan; LIU Xiaozhi; ZHENG Dawei; AN Long; XU Jinhua; WANG Dongwei; FAN Xianhui; LU Liaodong
Liaocheng Hospital of Traditional Chinese Medicine,Liaocheng 252000,Shandong,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換; 膝;  骨關(guān)節(jié)炎; 膝;  中藥療法;  化瘀滲濕湯;  D-二聚體;  纖維蛋白原;  治療; 臨床研究性
Keywords:
arthroplasty; replacement; knee;  osteoarthritis; knee;  drug therapy(TCD);  Huayu Shenshi Tang;  D- dimer;  fibrinogen;  therapies; investigational
摘要:
目的:探討口服化瘀滲濕湯對(duì)全膝關(guān)節(jié)置換術(shù)后血漿D-二聚體(D-dimer,DD)和纖維蛋白原(fibrinogen,FBG)含量的 影響。方法:將60例膝骨關(guān)節(jié)炎患者隨機(jī)分為2組,每組30例; 2組患者均進(jìn)行單側(cè)全膝關(guān)節(jié)置換術(shù),術(shù)后均皮下注射低分子 肝素鈣,雙下肢使用空氣壓力泵。其中1組患者在此基礎(chǔ)上予以化瘀滲濕湯口服。分別于術(shù)前、術(shù)后第1天和第7天測(cè)定并 比較2組患者血漿DD和FBG的含量。結(jié)果:手術(shù)前后不同時(shí)間點(diǎn)血漿DD含量比較,差異有統(tǒng)計(jì)學(xué)意義,存在時(shí)間效應(yīng) (F=137.114,P=0.001); 2組患者血漿DD含量比較,組間差異總體上有統(tǒng)計(jì)學(xué)意義,存在分組效應(yīng)(F=6.484,P=0.014); 術(shù)前 和術(shù)后第1天2組患者血漿DD含量比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義[(0.653±0.388)mg·L-1, (0.643±0.384)mg·L-1,t=0.104,P=0.918;(2.305±0.623)mg·L-1, (2.607±0.599)mg·L-1,t=-1.910,P=0.061]; 術(shù)后第7天低分子肝素鈣聯(lián)合空氣壓力泵和化瘀滲濕湯組 的血漿DD含量低于低分子肝素鈣聯(lián)合空氣壓力泵組[(0.530±0.249)mg·L-1,(0.790±0.225) mg·L-1,t=-4.246,P=0.001]; 時(shí)間因素與分組因素不存在交互效應(yīng)(F=2.498,P=0.099)。手術(shù)前后不同時(shí)間 點(diǎn)血漿FBG含量比較,差異有統(tǒng)計(jì)學(xué)意義,存在時(shí)間效應(yīng)(F=245.334,P=0.001); 2組患者血漿FBG含量比較,組間差異總體上 無(wú)統(tǒng)計(jì)學(xué)意義,不存在分組效應(yīng)(F=2.380,P=0.128); 術(shù)前和術(shù)后第1天2組患者血漿FBG含量比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義 [(3.010±0.511)g·L-1,(2.909±0.563)g·L-1,t=0.728,P=0.470; (4.621±0.421)g·L-1,(4.739±0.614)g·L-1,t=-0.870,P=0.388],術(shù)后第7天低分子 肝素鈣聯(lián)合空氣壓力泵和化瘀滲濕湯組的血漿FBG含量低于低分子肝素鈣聯(lián)合空氣壓力泵組[(2.958±0.397) g·L-1,(3.336±0.488)g·L-1,t=-3.294,P=0.002]; 時(shí)間因素與分組因素存在交互效應(yīng) (F=3.964,P=0.022)。結(jié)論:在皮下注射低分子肝素鈣聯(lián)合雙下肢使用空氣壓力泵的基礎(chǔ)上,給予口服化瘀滲濕湯,能降低 全膝關(guān)節(jié)置換術(shù)后血漿DD和FBG的含量,改善術(shù)后血液高凝、高黏狀態(tài),其效果優(yōu)于皮下注射低分子肝素鈣聯(lián)合雙下肢使用 空氣壓力泵。
Abstract:
Objective:To explore the effect of oral application of Huayu Shenshi Tang(HYSST)on plasma contents of D-dimer(DD)and fibrinogen(FBG)after total knee arthroplasty(TKA).Methods:Sixty patients with knee osteoarthritis were randomly divided into group A and group B,30 cases in each group.Unilateral TKA were performed on patients in both of the 2 groups.After the surgery,the patients were treated with subcutaneous injection of low-molecular-weight hepacarin(LMWH)and air force-pump in both lower limbs.Meanwhile,the patients in group B were treated with oral application of HYSST.The plasma contents of DD and FBG were measured and compared between the 2 groups before the operation and at the 1st and 7th day after the operation respectively.Results:There was statistical difference in the plasma DD contents between different timepoints before and after the operation,in other words,there was time effect (F=137.114,P=0.001).There was statistical difference in the plasma DD contents between the 2 groups in general,in other words,there was group effect(F=6.484,P=0.014).There was no statistical difference in the plasma DD contents between the 2 groups before the operation and at the 1st day after the operation (0.653+/-0.388 vs 0.643+/-0.384 mg/l,t=0.104,P=0.918; 2.305+/-0.623 vs 2.607+/-0.599 mg/l,t=- 1.910,P=0.061).The plasma DD contents were lower in group B compared to group A at the 7th day after the operation(0.530+/-0.249 vs 0.790+/-0.225 mg/l,t=-4.246,P=0.001).There was no interaction between time factor and grouping factor(F=2.498,P=0.099).There was statistical difference in the plasma FBG contents between different timepoints before and after the operation,in other words,there was time effect (F=245.334,P=0.001).There was no statistical difference in the plasma FBG contents between the 2 groups in general,in other words,there was no group effect(F=2.380,P=0.128).There was no statistical difference in the plasma FBG contents between the 2 groups before the operation and at the 1st day after the operation(3.010+/-0.511 vs 2.909+/-0.563 g/l,t=0.728,P=0.470; 4.621+/-0.421 vs 4.739+/-0.614 g/l,t=- 0.870,P=0.388).The plasma FBG contents were lower in group B compared to group A at the 7th day after the operation(2.958+/-0.397 vs 3.336+/-0.488 g/l,t=-3.294,P=0.002).There was interaction between time factor and grouping factor(F=3.964,P=0.022).Conclusion:Combination of oral application of HYSST with subcutaneous injection of LMWH and air force-pump in both lower limbs can decrease the plasma contents of DD and FBG after TKA,and improve the postoperative blood state of high coagulability and high viscosity,and its therapeutic effect is better than that of subcutaneous injection of LMWH combined with air force-pump in both lower limbs.

參考文獻(xiàn)/References:

[1] 張曉強(qiáng),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(duì)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(4):23-25.
[2] 齊志遠(yuǎn),陳秀民,王在斌,等.桃紅四物加黃芪湯預(yù)防人工髖膝關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成[J].中醫(yī)正 骨,2015,27(3):71-72.
[3] 石美鑫.實(shí)用外科學(xué)[M].北京:人民衛(wèi)生出版社,2002:1282.
[4] Cronan JJ.Deep vein thrombosis:imaging diagnosis and related controversies[J].Ultrasound Clin,2011,6 (4):421-433.
[5] Cosmi B,Palareti G.Update on the predictive value of D-dimer in patients with idiopathic venous thromboembolism[J].Thromb Res,2010,125(Suppl 2):S62-S65.
[6] Medved L,Nieuwenhuizen W.Molecular mechanisms of initiation of fibrinolysis by fibrin[J].Thromb Haemost,2003,89(3):409-419.
[7] Bounameaux H,Perrier A,Righini M.Diagnosis of venous thromboembolism:an update[J].Vasc Med,2010,15 (5):399-406.
[8] Pines JM,Everett WW.Pulmonary embolism and deep vein thrombosis[J].Lancet,2012,379(12):1436-1438.
[9] 王旭東,王晉峰.C-反應(yīng)蛋白和 D-二聚體在下肢深靜脈血栓形成中的臨床意義[J].山西醫(yī)藥雜志,2014,43(4):371- 373.
[10] Tripodi A.D-Dimer testing in laboratory practice[J].Clin Chem,2011,57(9):1256-1262.
[11] Mauriello A,Sangiorgi G,Palmieri G,et al.Hyperfibrinogenemia is associated with specific histocytological composition and complications of atherosclerotic carotid plaques in patients affected by transient ischemic attacks[J].Circulation,2000,101(7):744-750.
[12] Schutgens RE,Ackermark P,Haas FJ,et al.Combination of a normal D-dimer concentration and a non-high pretest clinical probability score is a safe strategy to exclude deep venous thrombosis [J].Circulation,2003,107(4):593-597.
[13] King A.Thrombosis:selective d-dimer testing improves efficiency of DVT diagnosis[J].Nat Rev Cardiol,2013,10(3):118.
[14] Bates SM,Jaeschke R,Stevens SM,et al.Diagnosis of DVT:antithrombotic therapy and prevention of thrombosis,9th ed:American college of chest physicians Evidence-Based clinical practice guidelines [J].Chest,2012,141(2 Suppl):e351S-e418S.
[15] 徐生根,毛兆光,朱慧華,等.骨科大手術(shù)前后監(jiān)測(cè)D-二聚體的意義[J].中國(guó)中西醫(yī)結(jié)合外科雜志,2009,15(6):636- 638.
[16] 趙慧茹,吳俊,馬海梅,等.血漿D-二聚體和纖維蛋白原對(duì)全膝關(guān)節(jié)置換術(shù)后急性下肢深靜脈血栓形成的診斷價(jià)值[J]. 醫(yī)學(xué)研究雜志,2013,42(11):85-88.

相似文獻(xiàn)/References:

[1]邢金明.切開(kāi)復(fù)位鎖定鋼板內(nèi)固定術(shù)和人工半肩關(guān)節(jié)置換術(shù) 治療老年肱骨近端復(fù)雜骨折的對(duì)比研究[J].中醫(yī)正骨,2015,27(08):11.
　XING Jinming.A retrospective trial of open reduction and locking plate internal fixation versus artificial shoulder hemiarthroplasty for complicated proximal humeral fractures in old patients[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):11.
[2]趙云昌.人工股骨頭置換治療老年粉碎性股骨轉(zhuǎn)子間骨折[J].中醫(yī)正骨,2015,27(08):31.
[3]張明強(qiáng).生物型加長(zhǎng)柄半髖關(guān)節(jié)置換術(shù)治療 高齡不穩(wěn)定股骨轉(zhuǎn)子間骨折療效觀察[J].中醫(yī)正骨,2015,27(02):56.
[4]蔡云仙.圍手術(shù)期耳穴按壓聯(lián)合平衡針療法 在全膝關(guān)節(jié)置換術(shù)后鎮(zhèn)痛中的應(yīng)用[J].中醫(yī)正骨,2015,27(06):41.
[5]喻長(zhǎng)純,楊明路,王戰(zhàn)朝.不同手術(shù)方式治療脛骨平臺(tái)骨折畸形愈合的體會(huì)[J].中醫(yī)正骨,2015,27(03):37.
[6]魏瑄,宋樹(shù)春,王金良.術(shù)前精確測(cè)量和評(píng)估在全髖關(guān)節(jié)置換治療 成人發(fā)育性髖關(guān)節(jié)發(fā)育不良繼發(fā)骨關(guān)節(jié)炎中的價(jià)值[J].中醫(yī)正骨,2015,27(01):30.
[7]鮑榮華,陳曉東,王國(guó)平,等.Wagner Cone生物型假體置換結(jié)合經(jīng)股骨轉(zhuǎn)子下橫形截骨 治療CroweⅣ型成人發(fā)育性髖關(guān)節(jié)發(fā)育不良[J].中醫(yī)正骨,2015,27(01):33.
[8]喻長(zhǎng)純,楊明路,王戰(zhàn)朝.同期髕骨脫位矯正術(shù)聯(lián)合全膝關(guān)節(jié)置換術(shù)治療 晚期膝骨關(guān)節(jié)炎合并習(xí)慣性髕骨脫位[J].中醫(yī)正骨,2015,27(01):41.
[9]武理國(guó),沈軍,傅國(guó)海,等.人工肱骨頭置換治療老年肱骨近端復(fù)雜骨折[J].中醫(yī)正骨,2013,25(10):70.
[10]李國(guó)梁,韓廣普,閆國(guó)強(qiáng),等.紅花化瘀湯薰蒸聯(lián)合理筋手法 在膝骨關(guān)節(jié)炎全膝關(guān)節(jié)置換術(shù)后康復(fù)中的應(yīng)用[J].中醫(yī)正骨,2013,25(12):31.
　Li Guoliang*,Han Guangpu,Yan Guoqiang,et al.Clinical application of HONGHUAHUAYU decoctions steaming combined with sinew adjusting manipulation in the postoperative rehabilitation of total knee arthroplasty in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(03):31.
[11]樊慶陽(yáng),任凱晶.定制3D打印切模輔助全膝關(guān)節(jié)置換術(shù)治療 膝骨關(guān)節(jié)炎合并股骨干骨折畸形愈合[J].中醫(yī)正骨,2015,27(11):37.
[12]李翰林,童培建.利福平聯(lián)合用藥配合保留假體清創(chuàng)治療 人工關(guān)節(jié)置換術(shù)后早期感染及低毒性感染[J].中醫(yī)正骨,2015,27(09):56.
[13]劉曉雅,孫永強(qiáng),劉國(guó)杰.主動(dòng)快速康復(fù)鍛煉對(duì)全膝關(guān)節(jié)置換術(shù)后關(guān)節(jié)活動(dòng)度的影響[J].中醫(yī)正骨,2015,27(09):73.
[14]張維平,康兩期,陳衛(wèi),等.全髖關(guān)節(jié)置換術(shù)圍手術(shù)期隱性失血的研究進(jìn)展[J].中醫(yī)正骨,2015,27(08):61.
[15]宋兵華,孫俊英,倪增良,等.全膝關(guān)節(jié)置換術(shù)前CT測(cè)量股骨后髁角的臨床意義[J].中醫(yī)正骨,2015,27(07):38.
[16]王金良,孫京濤,李玲,等.骨水泥聯(lián)合螺釘修復(fù)全膝關(guān)節(jié)置換術(shù)中 脛骨平臺(tái)內(nèi)側(cè)骨缺損[J].中醫(yī)正骨,2015,27(12):55.
[17]徐偉鋒,葉健,吳連國(guó).強(qiáng)骨飲對(duì)骨質(zhì)疏松性股骨頸骨折患者全髖關(guān)節(jié)置換術(shù)后 血清骨代謝生化指標(biāo)和骨密度的影響[J].中醫(yī)正骨,2015,27(02):12.
　XU Weifeng,YE Jian,WU Lianguo.Effect of Qianggu Yin(強(qiáng)骨飲,QGY)on serum bone metabolism indexes and bone density after total hip arthroplasty in patients with osteoporotic femoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(03):12.
[18]張榮,王健.人工全膝關(guān)節(jié)置換術(shù)的圍手術(shù)期心理護(hù)理[J].中醫(yī)正骨,2015,27(05):77.
[19]齊志遠(yuǎn),陳秀民,王在斌,等.桃紅四物加黃芪湯預(yù)防人工髖膝關(guān)節(jié)置換術(shù)后 下肢深靜脈血栓形成[J].中醫(yī)正骨,2015,27(03):71.
[20]陸吳超,季衛(wèi)鋒,馬鎮(zhèn)川.關(guān)節(jié)鏡下清創(chuàng)后持續(xù)灌洗聯(lián)合中藥口服治療 全膝關(guān)節(jié)置換術(shù)后急性期感染[J].中醫(yī)正骨,2015,27(01):51.

更新日期/Last Update: 2016-03-30