补肾活血法结合按摩预防老年髋膝关节置换术后下肢深静脉血栓形成的临床效果观察

The observation of clinical effects of kidney reinforcing and blood activating therapy combined with massage on the prevention of postoperative deep venous thrombosis in aged patients with hip and knee arthroplasty

目的 观察补肾活血法结合按摩预防老年髋膝关节置换术后下肢深静脉血栓形成（DVT）的临床疗效。方法将2014年3月-2015年10月我院91例行髋膝关节置换术后的老年患者随机分为两组,中医组46例,对照组45例。中医组口服补肾活血方加穴位按摩治疗,对照组使用依诺肝素加物理预防,观察两组术后第1、10天PT、APTT、D-二聚体、BPC、下肢静脉彩超检查及出血指标。结果 两组患者术后第10天的PT、APTT、D-二聚体及BPC均较术后第1天明显改善,差异均有统计学意义（均P〈0.05）;两组间各指标术后第1、10天差值比较差异均无统计学意义（均P〉0.05）;DVT发生率中医组为10.8%,对照组为12.2%,组间差异无统计学意义（P〉0.05）;两组术后引流量、血肿及瘀斑发生率比较,对照组明显高于中医组,差异有统计学意义（P〈0.05）。结论 补肾活血法结合按摩预防老年髋膝关节置换术后DVT形成效果良好,安全性高。

Objective To observe the clinical effects of kidney reinforcing and blood activating therapy combined with massage on the prevention of postoperative deep venous thrombosis （DVT） in the aged patients with hip and knee arthroplasty. Methods 91 aged patients who received hip and knee arthroplasty in our hospital from March 2014 to October 2015 were randomly divided into two groups with 46 cases in TCM group and 45 cases in control group.Pa- tients in TCM group orally took prescription of kidney reinforcing and blood activating therapy and acupoint massage, while patients in control group received enoxaparin combined with physical prevention.PT,APTT,D-dimmer,BPC,Color Doppler Ultrasound examinations of lower extremity veins and bleeding indexes of the two groups on the first day and 10th day after the operation were observed. Results PT,APTT,D-dimmer,and BPC of patients of the two groups on the 10th day after the operation significantly improved than those on the first day after the operation,the differences had statis- tical significance （all P〈0.01）;The differences value of each index on the first day after the operation and on the 10th day after the operation between the two groups had no statistical significance （all P〉0.05）;The incidence of DVT in the TCM group was 10.8% and with 12.2% in the control group,which had no statistical significance （P〉0.05）;Control group had obvious larger drainage volume and higher incidences of hematoma and ecchymosis than TCM group and the differ- ences showed statistical significance （P〈0.05）. Conclusion Kidney reinforcing and blood activating therapy combined with massage shows good effect and high safety on the prevention of DVT in aged patients with hip and knee arthro- plasty.