本文關(guān)鍵詞： 加味八珍湯 人工全膝關(guān)節(jié)置換術(shù) 隱性失血　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:在中醫(yī)藥理論指導(dǎo)下,觀察加味八珍湯對人工全膝關(guān)節(jié)置換(Total Knee Arthroplasty,TKA)術(shù)后隱性失血的影響,比較手術(shù)前后血紅蛋白(HB)、紅細(xì)胞比容(HCT),并觀察術(shù)中出血量、術(shù)后引流量及膝下腫脹程度,計算隱性失血量,探討加味八珍湯對減少全膝關(guān)節(jié)置換術(shù)后隱性失血的臨床療效,為防治全膝關(guān)節(jié)置換術(shù)后隱性失血提供有效的中醫(yī)藥治療方法和客觀的臨床依據(jù)。方法:采用臨床隨機對照方法,選取2016年2月至2017年2月在廣州中醫(yī)藥大學(xué)附屬骨傷科醫(yī)院住院治療并符合納入標(biāo)準(zhǔn)的病例共60例,按入院順序依次編號,通過查隨機數(shù)字表將患者分為觀察組及對照組,每組各30例。對照組予術(shù)后常規(guī)對癥治療,觀察組在對照組治療基礎(chǔ)上予加味八珍湯治療。觀察并記錄兩組患者術(shù)前、術(shù)后第1、3、7、10天紅細(xì)胞比容(HCT)、血紅蛋白(HB)的變化,比較術(shù)后兩組患者的隱性失血量。所有數(shù)據(jù)使用SPSS 19.0軟件進(jìn)行統(tǒng)計分析。結(jié)果:1.兩組患者術(shù)前紅細(xì)胞比容(HCT)、血紅蛋白(HB)、膝下腫脹程度比較,差異無統(tǒng)計學(xué)意義(P0.05)。2.兩組患者術(shù)中出血量、術(shù)后48h引流量及顯性失血量比較,差異無統(tǒng)計學(xué)意義(P0.05)。3.兩組患者術(shù)后隱性失血量比較,觀察組明顯低于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。4.兩組患者手術(shù)后HCT、HB下降后上升,組間比較差異有統(tǒng)計學(xué)意義(P0.05);兩組患者在術(shù)后第1天、第1-3天HCT、HB的減少值方面比較,差異無統(tǒng)計學(xué)意義(P0.05);在術(shù)后第3-7天、術(shù)后第7-10天HCT、HB的增加值方面比較,觀察組均明顯高于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。5.兩組患者術(shù)后第1、3天HB比較,差異無統(tǒng)計學(xué)意義(P0.05);術(shù)后第7、10天HB比較,觀察組均明顯高于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。6.兩組患者術(shù)后第3天、第7天、第10天膝下10cm腫脹程度比較,觀察組均明顯低于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:加味八珍湯能夠減少TKA患者術(shù)后的隱性失血量,隨著服藥時間的延長,能夠減輕TKA患者術(shù)后膝下腫脹程度,提升TKA患者術(shù)后的HB。
[Abstract]:Objective: to observe the effect of modified Bazhen decoction on recessive blood loss after total Knee arthroplasty (TKA) under the guidance of traditional Chinese medicine (TCM). Before and after operation, the hemoglobin HBs and erythrocyte volume of HCT were compared. The amount of blood loss during operation, postoperative drainage volume and the degree of subknee swelling were observed, and the amount of recessive blood loss was calculated. To explore the clinical effect of modified Bazhen decoction on reducing recessive blood loss after total knee arthroplasty. To provide effective Chinese medicine treatment and objective clinical basis for prevention and treatment of recessive blood loss after total knee arthroplasty. Methods: clinical randomized control method was used. From February 2016 to February 2017, 60 patients who were hospitalized in the affiliated Orthopaedics and Trauma Hospital of Guangzhou University of traditional Chinese Medicine and met the inclusion criteria were selected and numbered according to the order of admission. The patients were divided into observation group and control group with 30 cases in each group. The patients in the observation group were treated with modified Bazhen decoction on the basis of the treatment of the control group. The changes of erythrocyte specific volume (HCT) and hemoglobin (HBB) in the two groups were observed and recorded before and after operation. The recessive blood loss was compared between the two groups after operation. All the data were analyzed by SPSS 19.0 software. Results the RBC volume of two groups was compared before operation. There was no significant difference in the degree of subknee swelling between the two groups. The volume of blood loss during operation, the drainage volume and the amount of dominant blood loss 48 hours after operation were compared between the two groups. There was no significant difference between the two groups. The amount of recessive blood loss in the two groups was significantly lower than that in the control group. The difference was statistically significant (P 0.05). The HB of HCT was decreased and then increased in the two groups, and the difference between the two groups was statistically significant (P 0.05). There was no significant difference between the two groups in the decrease of HCT HB on the 1st and 1-3 days after operation (P 0.05). The increase of HCT HB in the observation group was significantly higher than that in the control group on the 3-7 days and 7-10 days after operation. There was no significant difference in HB between the two groups on the 1st day after operation (P 0.05). The HB of the observation group was significantly higher than that of the control group on the 7th day after operation, and the difference was statistically significant (P0.05U. 6.) on the 3rd and 7th day after operation, the patients in the observation group were significantly higher than those in the control group. On the 10th day, the swelling degree of 10 cm below the knee in the observation group was significantly lower than that in the control group. Conclusion: the modified Bazhen decoction can reduce the recessive blood loss after TKA patients, with the prolongation of medication time. It can reduce the degree of subknee swelling in patients with TKA and enhance the postoperative HB in patients with TKA.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R274.9
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本文編號：1457772