本文關(guān)鍵詞：當(dāng)歸補(bǔ)血湯加味對人工全髖關(guān)節(jié)置換術(shù)后患者凝血功能影響的研究　出處：《湖南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 當(dāng)歸補(bǔ)血湯加味 全髖關(guān)節(jié)置換術(shù) 下肢深靜脈血栓形成

【摘要】：目的:本研究擬通過觀察當(dāng)歸補(bǔ)血湯加味對臨床上人工全髖關(guān)節(jié)置換術(shù)后患者凝血功能包括凝血酶原時(shí)間(PT)、纖維蛋白原(FIB)、D-二聚體(D-Dimer)、活化部分凝血酶原時(shí)間(APTT)及血漿凝血酶時(shí)間(TT)的影響,研究該方對其中哪幾個(gè)指標(biāo)有明顯作用,來探討該方對人工全髖關(guān)節(jié)置換術(shù)后早期患者凝血功能的影響,研究防治術(shù)后DVT形成的部分作用機(jī)制。方法:通過納入及排除標(biāo)準(zhǔn),選取符合參研的對象60名,按隨機(jī)分配原則分為兩組(試驗(yàn)組及對照組),每組各30人,兩組患者性別、年齡經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn)無明顯差異(P0.05),具有可比性。兩組患者入院時(shí)行術(shù)前常規(guī)檢查。術(shù)前試驗(yàn)組合對照組分別單獨(dú)采用當(dāng)歸補(bǔ)血湯加味和單純低分子肝素鈣皮下注射預(yù)防下肢深靜脈血栓形成;自入院時(shí)開始應(yīng)用,術(shù)前12h停止應(yīng)用,術(shù)后12h、24h給予低分子肝素鈣皮下注射,后每天1次,術(shù)后用藥10天,其中試驗(yàn)組應(yīng)用當(dāng)歸補(bǔ)血湯加味口服,對照組單純應(yīng)用低分子肝素鈣皮下注射。術(shù)后2組患者均采用相同的基礎(chǔ)預(yù)防和物理預(yù)防措施,術(shù)后雙下肢彈力繃帶應(yīng)用3天,并適當(dāng)抬高患肢,術(shù)后第1天開始床上行下肢股四頭肌收縮及踝關(guān)節(jié)跖曲背伸功能鍛煉,術(shù)后第2天開始床上進(jìn)行患肢持續(xù)功能鍛煉。重點(diǎn)了解術(shù)前及術(shù)后第1、4、7、10天復(fù)查凝血酶原時(shí)間(PT)、纖維蛋白原(FIB)、活化部分凝血酶原時(shí)間(APTT)及血漿凝血酶時(shí)間(TT)、D-二聚體(D-Dimer)等凝血指標(biāo)的變化情況,并比較試驗(yàn)組和對照組之間及各組手術(shù)前后凝血功能差異并進(jìn)行療效分析。所有數(shù)據(jù)應(yīng)用SPSS18.0統(tǒng)計(jì)軟件分析。結(jié)果:兩組病例分別在術(shù)前、術(shù)后第1天、第4天、第7天及第10天5個(gè)時(shí)間點(diǎn)對凝血酶原時(shí)間(PT)、纖維蛋白原(FIB)、活化部分凝血酶原時(shí)間(APTT)及血漿凝血酶時(shí)間(TT)進(jìn)行記錄整理。并進(jìn)行重復(fù)資料統(tǒng)計(jì)學(xué)檢驗(yàn)。術(shù)后各時(shí)間點(diǎn)凝血酶原時(shí)間(PT)變化趨勢兩組間比較,試驗(yàn)組均比對照組延長,有顯著性差異(P0.05);纖維蛋白原(FIB)術(shù)后第1天、第7天、第10天三個(gè)時(shí)間點(diǎn)試驗(yàn)組明顯低于對照組(P0.05);活化部分凝血酶原時(shí)間(APTT)術(shù)后第1天、第4天、第7天兩個(gè)時(shí)間點(diǎn)試驗(yàn)組比對照組明顯延長(P0.05);血漿凝血酶時(shí)間(TT)術(shù)后第1天一個(gè)時(shí)間點(diǎn)試驗(yàn)組比對照組名選手延長(P0.05);D-二聚體(D-Dimer)術(shù)后各時(shí)段兩組間比較無明顯差異(P0.05);兩組病例中均未出現(xiàn)下肢深靜脈血栓(DVT)及肺栓塞(PTE)及死亡比例。兩組病例術(shù)前術(shù)后常規(guī)檢查比較經(jīng)統(tǒng)計(jì)學(xué)檢驗(yàn)。無顯著性差異(P0.05)。結(jié)論:當(dāng)歸補(bǔ)血湯加味能夠延長凝血酶原時(shí)間(PT)、活化部分凝血酶原時(shí)間(APTT)、降低纖維蛋白原(FIB)含量,來對全髖關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成(DVT)有一定預(yù)防作用。
[Abstract]:Objective: to observe the effect of modified Danggui Buxue decoction on coagulation function of patients after total hip arthroplasty including prothrombin time (PTT) and fibrinogen (FIBB). The effects of D-Dimern, activated partial prothrombin time (APTT) and plasma thrombin time (TTT) were studied. To explore the effect of this prescription on the coagulation function of early patients after total hip arthroplasty, and to study the mechanism of prevention and treatment of DVT. Methods: by including and excluding the criteria. According to the principle of random distribution, 60 subjects were selected and divided into two groups (experimental group and control group, 30 persons in each group. There was no significant difference in sex and age between the two groups by statistical test (P0.05)). Two groups of patients received routine examination before admission. The control group was treated with Danggui Buxue decoction alone and hypodermic injection of low molecular weight heparin calcium to prevent lower extremity deep vein thrombosis. It was given hypodermic injection of low-molecular-weight heparin calcium for 12 hours after operation, once a day after operation and 10 days after operation. The experimental group was treated with Danggui Buxue decoction and the control group was treated with hypodermic injection of low-molecular-weight heparin calcium. The two groups were treated with the same basic and physical preventive measures. The elastic bandages of the lower limbs were used for 3 days and the affected limbs were raised properly. The quadriceps muscle contraction and the ankle metatarsal flexion and extension function of the lower extremities were performed on the first day after the operation. Continuous functional exercise of the affected limb was performed on the second day after operation. The focus of this study was to review the prothrombin time (PTT) and fibrinogen (FIBB) before and after the operation for 710 days. The changes of activated partial prothrombin time (APTT) and plasma thrombin time (TTT) and D-Dimer (D-Dimer). The difference of coagulation function between the test group and the control group before and after operation was compared and the curative effect was analyzed. All the data were analyzed by SPSS18.0 statistical software. Results: the two groups of patients were before operation. On the 1st, 4th, 7th and 10th day after operation, the prothrombin time (PTT) and fibrinogen (FIBB) were observed. Activated partial prothrombin time (APTT) and plasma thrombin time (TTT) were recorded. The trend of change was compared between the two groups. The experimental group was longer than the control group, and the difference was significant (P 0.05). Fibrinogen FIBs were significantly lower in the experimental group than in the control group on the 1st, 7th and 10th day after operation. The activated partial prothrombin time (APTT) on the 1st, 4th and 7th day after operation in the experimental group was significantly longer than that in the control group. Plasma thrombin time (TTT) at one time point after operation in the trial group was longer than that in the control group (P 0.05). There was no significant difference between the two groups after D-Dimer operation (P 0.05). There were no DVT (DVT), PTET (pulmonary embolism) and death ratio in the two groups. The routine examination before and after operation was statistically compared between the two groups. There was no significant difference between the two groups (P 0.05). Conclusion: modified Danggui Buxue decoction can prolong prothrombin time (PTT). Activating partial prothrombin time and reducing the content of fibrinogen FIBs can prevent DVT after total hip arthroplasty.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R274.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 夏玉斌;肖靜蓉;;人工關(guān)節(jié)置換術(shù)后梯度壓力治療深靜脈血栓療效觀察[J];西部醫(yī)學(xué);2011年08期

2 黃仕光;;中藥干預(yù)對人工髖關(guān)節(jié)術(shù)后深靜脈血栓形成的影響[J];海南醫(yī)學(xué);2011年13期

3 王俊瑞;岳宗進(jìn);孫永強(qiáng);;當(dāng)歸補(bǔ)血湯合四妙散加減防治人工全膝關(guān)節(jié)置換術(shù)后深靜脈血栓46例[J];中醫(yī)研究;2011年03期

4 張晨;熊昌源;高駿;;下肢深靜脈血栓形成的中西醫(yī)治療進(jìn)展[J];湖北中醫(yī)學(xué)院學(xué)報(bào);2010年03期

5 依力哈木·買買提;賽力克·馬高維亞;;大劑量尿激酶治療急性下肢深靜脈血栓形成療效觀察[J];新疆醫(yī)學(xué);2009年02期

6 劉迅;童培建;章建華;;活血通脈湯防治全膝關(guān)節(jié)置換術(shù)后深靜脈血栓33例[J];浙江中醫(yī)藥大學(xué)學(xué)報(bào);2006年05期

7 偠禎研;偠普仁;;桃仁四物湯加味治療下肢深靜脈血栓11例臨床報(bào)告[J];亞太傳統(tǒng)醫(yī)藥;2006年08期

8 李婧;邱貴興;;靜脈血栓栓塞在骨科的預(yù)防與治療[J];中華骨科雜志;2005年12期

9 劉洪;下肢深靜脈血栓形成的治療進(jìn)展[J];海南醫(yī)學(xué);2005年10期

10 關(guān)振鵬,呂厚山,陳彥章,宋奕寧,秦秀龍,姜軍;影響人工關(guān)節(jié)置換術(shù)后下肢深靜脈血栓形成的臨床風(fēng)險(xiǎn)因素分析[J];中華外科雜志;2005年20期

，

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