腓股肌康复配合补肾益气活血方防治老年髋部骨折术后深静脉血栓形成

Bushen Yiqi Huoxue Fang in Combination with Massage on Prophylaxis of Deep Venous Thrombosis Following Postoperative Period of Aged Hip Arthroplasty

目的:观察补肾益气活血方与腓股肌康复预防老年髋关节置换术后深静脉血栓(DVT)形成的疗效。方法:将符合标准的90例行髋关节置换术患者按随机分为3组各30例。中医组服用补肾益气活血方加腓股肌康复穴位按摩,肝素组皮下注射依诺肝素,对照组服用阿司匹林肠溶片。观察3组术前、术后第1,10天患肢周径和肿胀率的变化,血小板(PLT),D-二聚体(D-D),凝血酶原时间(PT),部分凝血酶活化时间(aPTT)和下肢静脉彩超检查。结果:中医组患者术后肢体肿胀消退率明显优于对照组和肝素组(P<0.01);PLT,D-D,PT,aPTT术后1d3组比较,差异无统计学意义,术后10d中医组和对照组比较,差异呈显著性(P<0.01),中医组和肝素组比较,差异无显著性;中医组DVT1例(3.33%),肝素组DVT1例(3.33%),对照组DVT6例(20.0%),中医组术后DVT发生率明显低于对照组(P<0.01)。结论:补肾益气活血方与腓股肌康复预防老年髋关节置换术后DVT发生的效果好,安全性高。

Objective： The aim of this paper was to observe the effectiveness of Bushen Yiqi Huoxue Fang in combination with massage on prophylaxis of deep venous thrombosis （DVT） following postoperative period of aged hip arthroplasty. Method： Ninety patients receiving surgery by the same group of doctors were randomly divided into traditional Chinese medicine （TCM） group, low-molecular-weight heparin （LMWH） group and control group, postoperative patients in TCM group were treated with Bushen Yiqi Huoxue Fang in combination with massage. In the LMWH group, 30 patients were given LMWH after surgery; patiens in the control group took aspirin enteric-coated tablets. The limb circumference, routine blood test, blood coagulation function changes, hemodynamics of vessels by vascular ultrasound and the thrombosis were examined before surgery and one day, 10 days after surgery, respectively. Result： In limb circumference variation, there was significant difference the three groups （P 〈 0.01 ）. There was no significant difference of platelets, D-dimer （D-D）, prothrombin time （PT） , activeated partial thromboplastin time （aPTT） in all the three groups in the assay of one day after surgery, while significant difference （P 〈 0.01 ） appeared between the TCM group and the control group in the assay of 10 days after surgery. There was significant difference of the occurrence of DVT after surgery between the TCM group and the control group （P 〈0.01）. In TCM group, one DVT case （3.33%） was discovered. In LMWH group, one DVT case （3.33%） was discovered as well. While in the control group, 6 DVT cases （20.0%） were found. Conclusion： On the basis of this study, it is more effeetive and safer to use Bushen Yiqi Huoxue Fang in combination with massage on prophylaxis of DVT following postoperative period of aged hip arthroplasty.