不同方案治疗手部创伤后早期肿胀的疗效比较

Clinical contrast of different treatment regimens for post- traumatic swelling of hand

目的探讨不同方案治疗手外伤后肢体肿胀的疗效,指导临床用药。方法将96例手外伤患者以受伤时间为序随机分为3组:单纯甘露醇组(A组),单纯七叶皂甙钠组(B组),小剂量甘露醇和七叶皂甙钠联合应用组(C组),每组32例。观察不同组别患者的消肿时间及疗效。结果 A、B、C三组患者手部肿胀平均消退时间分别为5.56d,5.44 d和4.10 d,显效率A组84.38%、B组90.63%、C组96.88%。统计结果显示三组患者在手部消肿时间及疗效上其差异具有显著性(P<0.05),进一步组间比较显示C组患者的手部消肿时间明显短于A、B组(P<0.01),疗效明显优于A、B组(P<0.05)。但A、B组之间比较消肿时间和疗效差异无显著性(P>0.05)。结论甘露醇与七叶皂甙钠治疗手部创伤后早期肿胀均具有良好的消肿作用,两者联合应用时其疗效更为明显。本研究三种治疗方案中,我们更为推荐联合应用方案。

Objective To explore the clinical outcomes of different treatment regimens on post- traumatic swelling of hand. Methods A total of 96 patients with post- traumatic hand swelling were randomly divided into 3 groups（ n = 32 in each）. In group A,32 patients were only treated with mannitol. In group B,32 patients were only treated with sodium aescinate. In group C,32 patients were treated with sodium aescinate combined with low dosage of mannitol. The variation in subsidence of hand swelling and effective rate in these 3 groups were observed respectively.Results The average durations for subsidence of hand swelling were 5. 56 d,5. 44 d and 4. 10 d respectively and their overall effective rates after treatment were 84. 38%,90. 63% and 96. 88% respectively. There was significantly difference among these three groups（ P〈0. 05）. Further comparison among these groups showed that the average time for subsidence of hand swelling in group C was earlier than that of group A and B,and the overall effective rate of group C was much better than that of group A and B（ P〈0. 05）. But there was no significant difference between group A and B（ P〉0. 05）. Conclusion Both mannitol and sodium aescinate have obvious effect for anti- effusion and subsidence of hand swelling. The joint application of mannitol and sodium aescinate has prominent effect. Plan C is simple,effective and quick in methods for treatment of traumatic hand swelling,hence plan C is worthy to be recommended.