本文選題：下肢靜脈曲張　切入點：中藥　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:全面的觀察中藥對小腿部大隱靜脈曲張微創(chuàng)治療術(shù)后疼痛、皮下瘀血、血栓性靜脈炎、隱神經(jīng)損傷、色素沉著等并發(fā)癥的預(yù)防性作用。方法:選擇2016年1月-12月單純大隱靜脈曲張患者134例,隨機分為中藥治療組(a、b組)和對照組(c、d組)。4組病例大腿段均行大隱靜脈曲張高位結(jié)扎+大腿段主干剝脫,中藥治療組圍手術(shù)期口服中藥(自擬方),對照組不服用中藥,中藥a組(35例)和對照c組(33例)小腿部行泡沫硬化劑(1%聚多卡醇)注射治療;中藥b組(34例)和對照d組(32例)小腿部行腔內(nèi)激光灼閉術(shù);四組術(shù)后予彈力繃帶加壓包扎3天,后改用醫(yī)用彈力襪3個月。術(shù)后3天、1周、1個月、3個月隨訪。比較分析中藥組與對照組組間,四組之間術(shù)后疼痛、皮下瘀血、深靜脈血栓形成、癥狀性肺栓塞、血栓性靜脈炎、隱神經(jīng)損傷、色素沉著、過敏性皮炎、皮膚灼傷等并發(fā)癥的情況。結(jié)果1.中藥組與對照組術(shù)后并發(fā)癥比較1.1術(shù)后疼痛中藥組術(shù)后疼痛優(yōu)于對照組,P≈0.0000.05,差異有統(tǒng)計學(xué)意義。1.2中藥組血栓性淺靜脈炎、色素沉著、皮下瘀血優(yōu)于對照組,P0.05,差異有統(tǒng)計學(xué)意義;深靜脈血栓形成、皮膚灼傷等并發(fā)癥,中藥組發(fā)病例數(shù)少于對照組,但無統(tǒng)計學(xué)差異。2.亞組之間術(shù)后并發(fā)癥比較2.1術(shù)后疼痛中藥a組優(yōu)于中藥b組,中藥b組優(yōu)于對照c組,對照c組優(yōu)于對照d組,P0.05,有統(tǒng)計學(xué)意義。2.2深靜脈血栓形成僅對照d組出現(xiàn)1例深靜脈血栓形成患者,與其余三組比較,P0.05,無統(tǒng)計學(xué)差異。2.3血栓性淺靜脈炎中藥a組優(yōu)于中藥b組和對照c、d組,對照c組和優(yōu)于對照d組,P0.05,有統(tǒng)計學(xué)差異。2.4色素沉著中藥b組和對照d組色素沉著并發(fā)癥均優(yōu)于中藥a組和對照c組,中藥a組優(yōu)于對照c組,P0.05,有統(tǒng)計學(xué)差異。2.5隱神經(jīng)損傷中藥a組隱神經(jīng)損傷優(yōu)于中藥b組和對照d組;對照c組隱神經(jīng)損傷優(yōu)于中藥b組和對照d組,P0.05,有統(tǒng)計學(xué)差異。2.6皮下瘀血中藥a組皮下瘀血并發(fā)癥均優(yōu)于中藥b組和對照d組,對照c組和中藥b組均優(yōu)于對照d組,P0.05,有統(tǒng)計學(xué)差異。2.7皮膚灼傷中藥a組和對照c組未現(xiàn)皮膚灼傷,均優(yōu)于對照d組,P0.05,有統(tǒng)計學(xué)差異。結(jié)論1.中藥組術(shù)后疼痛、血栓性淺靜脈炎、色素沉著、皮下瘀血優(yōu)于對照組,P0.05,有統(tǒng)計學(xué)差異;深靜脈血栓形成、皮膚灼傷等并發(fā)癥例數(shù)少于對照組,但無統(tǒng)計學(xué)差異。2.中藥+泡沫硬化劑注射治療組(中藥a組)術(shù)后并發(fā)癥最少,優(yōu)于其他三個亞組,差異有統(tǒng)計學(xué)意義。3.泡沫硬化劑注射治療與激光灼閉術(shù)治療相比,術(shù)后血栓性淺靜脈炎、隱神經(jīng)損傷、皮下瘀血、皮膚灼傷等并發(fā)癥更少、更輕。
[Abstract]:Objective: to observe the effect of traditional Chinese medicine on the minimally invasive treatment of great saphenous vein varicose vein in the leg after operation, such as pain, subcutaneous blood stasis, thrombotic phlebitis and saphenous nerve injury. Methods: 134 patients with varicose great saphenous vein from January to December 2016 were selected. They were randomly divided into two groups: the Chinese medicine treatment group (group B) and the control group (group B). The thigh segment of the patients in the control group was treated with varicose varicose great saphenous vein ligation of the thigh segment at high position. The Chinese medicine was taken orally in the Chinese medicine treatment group during the perioperative period (self-prescription, the control group did not take Chinese medicine). Group A (n = 35) and control group C (n = 33) were treated by injection of foam-sclerosing agent (1% polybutanol), group B (n = 34) and control group (n = 32) were treated with intracavitary laser cauterization. The four groups were followed-up with elastic bandages for 3 days, and then with medical elastic socks for 3 months. The patients were followed up for 1 week, 1 month and 3 months after operation. The postoperative pain and blood stasis were compared between the traditional Chinese medicine group and the control group. Deep venous thrombosis, symptomatic pulmonary embolism, thrombotic phlebitis, saphenous nerve injury, pigmentation, allergic dermatitis, Results 1.Compared with the control group, the postoperative pain in the traditional Chinese medicine group was better than that in the control group (P 鈮，

本文編號：1699155