本文選題：紅花黃色素　切入點：低分子量肝素鈉　出處：《福建中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:觀察紅花黃色素聯(lián)合低分子量肝素鈉預防全膝關節(jié)置換術后下肢深靜脈血栓形成的臨床療效、安全性,并初步探討其作用機制。方法:收集自2015年11月至2016年6月收住入山東省文登整骨醫(yī)院關節(jié)三科符合納入標準的實行初次單側(cè)全膝關節(jié)置換術患者60例,按入院先后順序編號,依照隨機數(shù)字表分為A組、B組、C組。A組于術后12小時后予低分子量肝素鈉5000IU,皮下注射,每天一次。B組于術后12小時后給予注射用紅花黃色素150mg,加入250ml生理鹽水中靜脈滴注,每天一次;同時予低分子量肝素鈉5000IU,皮下注射,每天一次。C組于術后12小時后給予注射用紅花黃色素150mg,加入250ml生理鹽水中靜脈滴注,每天一次;同時予低分子量肝素鈉2500IU,皮下注射,每天一次。分別于術前、術后第1、3、14天觀察比較三組患者的血漿D-二聚體、凝血酶原時間和部分凝血活酶時間、C反應蛋白、血清白介素-6值;患膝疼痛評分、術后24h引流量、血小板計數(shù)、血紅蛋白含量及瘀斑面積;血栓及不良反應發(fā)生情況。對收集到的數(shù)據(jù)使用SPSS20.0軟件進行統(tǒng)計學分析。結(jié)果:本次研究共納入病例60例,完成隨機分組后,A、B、C三組各20例。治療期間A組1名患者自行服用阿司匹林,C組1名患者自行提前出院,實際完成58例。血漿D-二聚體、凝血酶原時間、部分凝血活酶時間、C反應蛋白、血清白介素-6、VAS評分方面,術后第1、3、14天組間同一時間點相比較,A組與B、C組有統(tǒng)計學差異(p0.05);B組與C組相比無統(tǒng)計學差差異(p0.05)。三組患者術后引流量無統(tǒng)計學差異。A組DVT發(fā)生率為5.26%,B、C組均為0%,三組相比較,p=0.3220.05,三組在DVT發(fā)生率上并無統(tǒng)計學差異。血小板計數(shù)和血紅蛋白含量方面,術后第1、3、14天A、B組與C組組間同一時間點相比較,p0.05,差異有統(tǒng)計學意義;A組與B組相比p0.05,差異無統(tǒng)計學意義�；贾霭呙娣e方面比較,三組組間相比術后第一天差異無統(tǒng)計學意義(p0.05);術后第3、14天,C組與A、B組差異有統(tǒng)計學意義(p0.05),A組與B組無統(tǒng)計學差異(p0.05)。結(jié)論:人工全膝關節(jié)置換術后應用紅花黃色素聯(lián)合低劑量低分子量肝素鈉,能有效改善術后血液高凝狀態(tài),減少術后出血量、減輕術后疼痛,并可有效降低IL-6、CRP水平;還可有效減少血小板及血紅蛋白丟失。在預防下肢深靜脈血栓形成方面臨床療效滿意,且副作用小,安全性更高,值得得臨床推廣。
[Abstract]:Objective: to observe the clinical efficacy and safety of safflower yellow and low molecular weight heparin sodium in prevention of deep vein thrombosis after total knee arthroplasty. Methods: from November 2015 to June 2016, 60 patients with primary unilateral total knee arthroplasty who were admitted to three departments of joint in Wendeng whole Bone Hospital of Shandong Province were collected and numbered according to the order of admission. According to the random digital table, group A was divided into group A, group B, group C, group C, group A were given low-molecular-weight heparin sodium (LMWH) 5 000 IUU 12 hours after operation, group .B was injected with 150 mg of safflower yellow pigment once a day 12 hours after operation, and 250 ml of normal saline was added intravenously. At the same time, low molecular weight heparin sodium 5 000 IUS was injected subcutaneously. Group C was injected with 150 mg safflower yellow pigment 12 hours after operation, and 250 ml normal saline was added intravenously once a day. The plasma D-dimer, prothrombin time, partial thromboplastin time and serum interleukin-6 were observed and compared between the three groups before and after the operation, respectively, by subcutaneous injection of low-molecular-weight heparin sodium 2500 IUU once a day. Knee pain score, postoperative 24 hours drainage, platelet count, hemoglobin content and ecchymosis area; The incidence of thrombus and adverse reactions. The collected data were statistically analyzed using SPSS20.0 software. Results: 60 cases were included in this study. During the course of treatment, one patient in group A took aspirin and one patient in group C left hospital early, 58 cases were actually completed. Plasma D- dimer, prothrombin time, prothrombin time, plasma D- dimer, prothrombin time, plasma D- dimer, prothrombin time, prothrombin time, plasma D- dimer, prothrombin time, Partial thromboplastin time and C-reactive protein, serum interleukin-6 and VAS score, There was no statistical difference between group A and group C at the same time point on the 1st day after operation (P 0.05). There was no statistical difference between group B and group C. there was no significant difference in postoperative drainage among three groups. The incidence of DVT in group A was 0 in group C (5.26%) and in group C (0%). Compared with 0.3220.05, there was no significant difference in the incidence of DVT among the three groups. The difference between group A and group C at the same time point was significant (P 0.05). There was no significant difference between group A and group B (P 0.05), but the area of ecchymosis was not significantly different between group A and group B (P 0.05), but there was no significant difference between group A and group B (P 0.05). There was no significant difference between the three groups on the first day after operation, and there was no significant difference between group C and group A on the 14th day after operation, and there was no significant difference between group A and group B. conclusion: the application of safflower yellow pigment after total knee arthroplasty is not significant (p 0.05). Combined with low dose low molecular weight heparin sodium, It can effectively improve the state of blood hypercoagulability, reduce the amount of blood loss, relieve postoperative pain, decrease the level of IL-6 CRP, reduce the loss of platelet and hemoglobin, and is effective in preventing deep venous thrombosis of lower extremity. And the side effect is small, the safety is higher, is worth to be popularized clinically.
【學位授予單位】：福建中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

【參考文獻】

相關期刊論文 前10條

1 鄭碩;楊寶鐘;邢彤;曹剛;黃強;王吉亭;胡璇;李鐵;曹建春;;下肢深靜脈血栓形成急性期及亞急性期炎癥細胞和體溫變化與中醫(yī)證型相關性分析[J];中國中醫(yī)藥信息雜志;2017年03期

2 馮陽陽;周煜虎;劉向棟;武政;;疏血通聯(lián)合依諾肝素治療髖關節(jié)置換術后下肢深靜脈血栓的療效及其對凝血功能的影響[J];檢驗醫(yī)學與臨床;2016年21期

3 黃中武;;運動療法對人工膝關節(jié)置換術后下肢深靜脈血栓形成預防的效果觀察[J];海南醫(yī)學院學報;2016年22期

4 陳貞君;方嘉陽;邱星穎;沈豐豐;傅祥湞;戢婷;李華;;丹參川芎嗪注射液聯(lián)合鹽酸氟桂利嗪預防下肢骨折術后長期臥床患者陣發(fā)性位置性眩暈及下肢深靜脈血栓的臨床觀察[J];中國藥房;2016年17期

5 王育苗;;血府逐瘀湯對血栓形成及血液流變學的影響[J];內(nèi)蒙古中醫(yī)藥;2016年03期

6 田爭艷;宋良;張艷艷;苑學;李艷菊;;華法林與利伐沙班預防老年髖部骨折術后下肢靜脈血栓比較[J];中國藥業(yè);2015年22期

7 高海s，

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