益气活血通络汤对老年髋关节置换术后下肢深静脉血栓形成及局部血液循环、凝血和纤溶功能的影响

Effects of Yiqi Huoxue Tongluo decoction on lower extremity deep venous thrombosis,local blood circulation,coagulation and fibrinolysis function after hip replacement in the elderly

目的探究益气活血通络汤对老年髋关节置换术后下肢深静脉血栓形成及局部血液循环、凝血和纤溶功能的影响。方法择取2020年1月至2021年5月于我院接受髋关节置换术治疗的92例老年患者为研究对象,根据治疗方案的不同将其分为对照组与观察组,各46例。对照组术后给予常规治疗,观察组在对照组治疗基础上施加益气活血通络汤。比较两组的治疗效果。结果观察组的下肢深静脉血栓形成率为2.17%,低于对照组的21.74%(P<0.05)。治疗后,两组的搏动指数(PI)、阻力指数(RI)均降低,踝肱指数(ABI)均升高,且观察组优于对照组(P<0.05)。治疗后,两组的血栓调节蛋白(TM)、纤溶酶-抗纤溶酶复合物(PIC)、组织型纤溶酶原激活抑制复合物(t-PAIC)水平均降低,凝血酶抗凝酶复合物(TAT)水平升高,且观察组优于对照组(P<0.05)。治疗后,两组的Harris髋关节评分、Fugl-Meyer下肢评价量表(FMA-LE)、Holden步行功能分级量表(FAC)评分均升高,且观察组高于对照组(P<0.05)。结论老年髋关节置换术后给予益气活血通络汤能有效改善患者局部血液循环、凝血和纤溶功能,减少下肢深静脉血栓形成,促进下肢功能恢复,值得推广。

Objective To explore the effects of Yiqi Huoxue Tongluo decoction on lower extremity deep venous thrombosis,local blood circulation,coagulation and fibrinolysis function after hip replacement in the elderly.Methods A total of 92elderly patients underwent hip replacement in our hospital from January 2020 to May 2021 were selected as the research objects.According to the different treatment plan,the patients were divided into control group and observation group,with46 cases in each group.The control group was given routine treatment after operation,and the observation group was treated with Yiqi Huoxue Tongluo decoction on the basis of the control group.The therapeutic effects of the two groups were compared.Results The incidence of lower extremity deep venous thrombosis in the observation group was 2.17%,which was lower than 21.74%in the control group(P<0.05).After treatment,the pulsatility index(PI)and resistance index(RI)of the two groups decreased,the ankle brachial index(ABI)increased,and those in the observation group were better than the control group(P<0.05).After treatment,the levels of thrombomodulin(TM),plasmin antiplasmin complex(PIC)and tissue plasminogen activator inhibitor complex(t-PAIC)in the two groups decreased,while the level of thrombin-antithrombin complex(TAT)increased,and those in the observation group were better than the control group(P<0.05).After treatment,the Harris hip score,Fugl-Meyer Assessment-Lower Extremity(FMA-LE)and Functional Ambulation Category Scale(FAC)scores of the two groups increased,and those in the observation group were higher than the control group(P<0.05).Conclusion After hip replacement in the elderly,Yiqi Huoxue Tongluo decoction can effectively improve the local blood circulation,coagulation and fibrinolysis function of patients,reduce the formation of deep venous thrombosis of lower limbs,and promote the recovery of lower limb function,which is worthy of promotion.