中西医结合在髋关节置换术后的应用效果及对患者预后的影响

Application of Traditional Chinese and Western Medicine after Hip Arthroplasty and Effects on Prognosis of Patients

目的:探讨中西医结合疗法在髋关节置换术后的应用效果及对患者预后的影响。方法:选取2016年4月至2017年4月北京市隆福医院收治的行髋关节置换术治疗的患者82例,按照随机数字表法随机分为对照组和观察组,每组41例。2组均行髋关节置换术并进行围手术期基本预防措施,对照组术后给予低分子肝素钙注射液治疗,观察组在对照组的基础上给予活血舒筋汤治疗,2组均连续治疗3周。比较2组术前、术后3 d、14 d血浆D-二聚体水平及凝血功能指标变化,统计2组术后深静脉血栓(DVT)发生率,观察术前及术后2组髋关节功能及疼痛程度变化,统计2组临床疗效。结果:与术前比较,术后3 d 2组D-二聚体、纤维蛋白原(Fib)水平均明显升高,凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均明显降低,术后14 d观察组D-二聚体、Fib水平明显降低,PT、APTT明显升高(P <0. 05),且2组术后3～14 d上述指标比较,差异有统计学意义(P <0. 05);术后观察组DVT发生率显著低于对照组(P <0. 05);与术前比较,术后2组Harris髋关节评分均显著升高,疼痛视觉模拟量表法(VAS)显著降低,且2组差异有统计学意义(P <0. 05); 2组总优良率比较,差异无统计学意义(P> 0. 05)。结论:中西医结合治疗可有效改善髋关节置换术后患者血液高凝状态,降低DVT发生率,同时有利于患者髋关节功能恢复,改善预后。

Objective:To explore the application effect of traditional Chinese and western medicine after hip arthroplasty and the effect on prognosis of patients.Methods:A total of 82 cases patients who were treated with hip arthroplasty in Fulong Hospital of Beijing City from April 2016 to April 2017 were selected and randomly divided into research group and control group,with 41 cases in each group.Both groups were treated with hip arthroplasty and the perioperative basic preventive measures.The control group was treated with low molecular heparin calcium injection,the research group was treated with Huoxue Shujin decoction on the basis of control group,and 2 groups were treated continuously for 3 weeks.Compared the level of plasma D-D and the changes of blood coagulation function index in 2 groups preoperative,3 and 14 days postoperative,statisticsed the postoperative DVT incidence of the 2 groups,observed the changes of hip joint function and the degree of pain preoperative and after treatment in 2 groups,statisticsed the clinical efficacy of 2 groups.Results:Compared with preoperative,3 days postoperative the levels of D-D and Fib significantly increased and the levels of PT,APTT significantly decreased in 2 groups,14 days postoperative the levels of D-D and Fib significantly decreased and the levels of PT,APTT significantly increased in research group (P<0.05 or P<0.01),and the difference between 2 groups was significant 3-14 days postoperative (P<0.05 or P<0.01):Postoperative the incidence of DVT in research group was significantly lower than that in control group (P<0.05):Compared with preoperative,after treatment the Harris hip score significantly increased and VAS significantly decreased in 2 groups,and the difference between 2 groups was significant (P<0.01).The total excellent and good ratio had no significant difference between 2 groups (P>0.05).Conclusion:Traditional Chinese and western medicine treatment can effectively improve the blood hypercoagulable state of patients after hip arthroplasty,reduce the incidence of DVT,while the treatment can help patients with hip joint function recovery,improve the prognosis.