加味补阳还五汤外敷预防全膝关节置换术后小腿肌间静脉血栓的临床观察

Clinical Observation on External Application of Jiawei Buyang Huanwu Decoction(加味补阳还五汤)to Prevent Intermuscular Venous Thrombosis of the Calf after Total Knee Arthroplasty

目的:探讨加味补阳还五汤外敷预防人工全膝关节置换术后患者小腿肌间静脉血栓的效果。方法:纳入2021年3月至2022年3月在湖南中医药大学第二附属医院行单侧人工全膝关节置换术的46例患者作为研究对象,将其分为对照组与试验组,每组各23例。其中对照组采取常规护理与抗凝治疗,试验组在对照组的基础上联合加味补阳还五汤外敷治疗。比较两组患者的术后血栓发生率,术后第1天与第10天的D-二聚体值、凝血酶原时间与部分凝血酶原时间,护理满意度。结果:试验组的术后血栓发生率明显低于对照组(P<0.05);两组患者术后第1天的D-二聚体值、凝血酶原时间与部分凝血酶原时间比较,差异均无统计学意义(P>0.05),试验组患者术后第10天的D-二聚体值明显低于对照组(P<0.05),凝血酶原时间与部分凝血酶原时间明显短于对照组(P<0.05);对照组护理满意度为82.6%(19/23),试验组护理满意度为91.3%(21/23),两组患者的护理满意度比较,差异无统计学意义(P>0.05)。结论:对于人工全膝关节置换术后的患者,在常规护理与抗凝的基础上,联合加味补阳还五汤外敷可降低术后小腿肌间静脉血栓的发生率,效果显著且安全,值得推广。

Objective:To investigate the effect of external application of Jiawei Buyang Huanwu Decoction(JWBYHWD)on preventing intermuscular venous thrombosis in patients after total knee arthroplasty.Methods:A total of 46 patients who underwent unilateral total knee arthroplasty in the Second Affiliated Hospital of Hunan University of Chinese Medicine from March 2021 to March 2022 were included as research subjects.They were divided into control group and experimental group,with 23 patients in each group.The control group received routine nursing and anticoagulation therapy,and on the basis of the control group,the experimental group was treated with external application of JWBYHWD.The incidence of postoperative thrombosis,D-dimer value,prothrombin time and partial prothrombin time on the 1st and 10th postoperative day,and nursing satisfaction were compared between the two groups.Results:The incidence of postoperative thrombosis in the experimental group was significantly lower than that in the control group(P<0.05).There was no significant difference between the two groups in D-dimer value,prothrombin time and partial prothrombin time on the first day after surgery(P>0.05).The D-dimer value of the experimental group on the 10th day after surgery was significantly lower than that of the control group(P<0.05),and the prothrombin time and partial prothrombin time were significantly shorter than those of the control group(P<0.05).The nursing satisfaction of the control group was 82.6%(19/23),and that of the experimental group was 91.3%(21/23).There was no significant difference between the two groups(P>0.05).Conclusion:For patients after total knee arthroplasty,on the basis of routine nursing and anticoagulation,combined with external application of JWBYHWD can reduce the incidence of postoperative calf intermuscular venous thrombosis,the effect was significant and safe,and it was worthy of promotion.