毛冬青汤结合关节镜技术治疗大腿皮下巨大血肿1例

Treating 1 case of giant subcutaneous hematoma of thigh with the Maodongqing decoction plus arthroscopy

皮下血肿是指直径大于10 mm的皮肤下出血,局部常可扪及液波感或视诊时皮肤隆起,伴或不伴胀痛。西医治疗方法有其局限性,中医主要治法为活血化瘀,消肿止痛。文章采用案例分析方式探讨中医治疗皮下血肿的优势。现选取湖南中医药大学第三附属医院收治的一位车祸重伤导致大腿皮下巨大血肿患者进行分析,该患者在外院经长期引流治疗效果不佳,反复发作,就诊后,使用关节镜清理联合毛冬青汤内服治疗。术后,使用弹力绷带加压包扎,所有血肿得到完全清除,皮肤与深筋膜愈合良好,皮肤柔软度良好,关节活动良好,未见明显疼痛及液波感,无复发、无血管及神经损伤。临床表明,关节镜联合毛冬青汤治疗皮下血肿具有创伤小、恢复快、术后不易复发等优点。术前及术后联用毛冬青汤能达到活血化瘀、清热利水、补益气血的功效。文章介绍此案例,以期为临床提供参考。

Subcutaneous hematoma refers to subcutaneous hemorrhage greater than 10 mm in diameter,often with palpable fluid sensation or visual skin bulge,with or without tenderness.Western medicine has limitations,and the main treatment methods of TCM are activating blood circulation and removing stasis,reducing swelling and relieving pain.This paper reported one case to explore the advantages of TCM in the treatment of subcutaneous hematomas.The Third Affiliated Hospital of Hunan University of Chinese Medicine admitted one patient with huge subcutaneous hematoma of the thigh after a car accident.The patient had poor effects and repeated episodes after long-term drainage treatment in another hospital.After coming to our hospital,arthroscopic cleaning plus the Maodongqing decoction(毛冬青汤)for internal treatment was applied.After surgery,the patient was given elastic bandage pressure dressing.All of postoperative hematoma was completely removed,and the skin and deep fascia obtain good healing,with skin softness,good joint mobility,without obvious pain and fluid wave feeling,recurrence,blood vessel and nerve damage.The arthroscopy plus the Maodongqing decoction in treating subcutaneous hematoma has the advantages of less trauma,faster recovery and less recurrence after operation.This paper presents this case in order to provide a clinical reference.