三七总皂甙预防髋关节置换术后下肢深静脉血栓形成的临床分析-中医骨伤科学专业论文.docxVIP

优于对照组（P﹤0.01），术后7d两组间髌上10cm周径差异有统计学意义（P﹤0.05）。术后1d两组血红蛋白量与术前相比有显著性差异（P﹤0.01），术后3d与术前相比有统计学差异（P﹤0.05）。术后两组血红蛋白量均回升，对照组术后7d与术前相比及两组间比较血红蛋白量有统计学差异（P﹤0.05）。术后伤口的出血量观察组301.6±84.8ml，对照组375.6±74.8ml，观察组优于对照组，有统计学意义（P﹤0.05）。观察组出现瘙痒性皮疹1例，未出现出血病例；对照组出现皮肤瘀斑3例，齿龈出血4例，尿血1例，共8例。两组用药后并发症发生率有统计学意义（P﹤0.05）。结论：PNS可以明显提高股静脉血流速度，缓解血流瘀滞，降低血液高凝状态，抑制血栓形成，对LDVT发生的预防与华法林未有显著差异，作用相似，可明显降低术后LDVT发生率；但PNS无明显诱发、加重出血及其它并发症，无需检测用药，安全性高，优于华法林。可以明显减轻术后肢体肿胀，说明中药在改善髋部大手术后肢体肿胀具有一定的优势。PNS预防人工髋关节臵换术后LDVT形成安全、有效、价格经济，值得临床推广应用。关键词：三七总皂甙；髋关节臵换术；血栓；深静脉；预防TheclinicalresearchofPanaxNotogi-nsengSaponinsinprophylaxisfordeepveinthrombosisafterartificialhipreplacementABSTRACTObjective:ToevaluatetheeffectivenessandsafetyofPanaxNotogi-nsengSaponins(PNS)inprophylaxisfordeepveinthrombosisafterartificialhipreplacement.Methods:FromOctober2006toDecember2007,60PatientsundergoingtotalhiparthroplastyintheRuikangHospitalaffiliatedtoGuangxicollegeofTraditionalChineseMedicine.Theywere34malesand26females.Theirageswerefrom35y-88yandaveragewas65.73y.Theyweredouble-blindrandomizedinto2groupsforlowerlimbdeepveinthrombosis(LDVT)prophylaxis.ThecontrolGroup(30)weredailyreceivedWarfarinSodiumTablets2.5mg,TheobserverGroup(30)receivedPanaxNotoginsengSaponins(PNS)400mg+5%G.S250ml,bothoneachdayofthe7daysafteroperation.Towgroupreceivedthesameoperationandothertreatments,thevolumeofdrainage,complicationsandswellingoflowerlimbafteroperationwererecorded.Atthesametime,bloodsampleswereretrievedforrheologyevaluation.AndallthepatientsreceivedCDFI(ColorDopplerFlowImage)examinationthedaybeforeoperationandondays7afteroperationtoobservethebloodflowrateoffemoralveinandtheoccurrenceofLDVT.AllofstatisticwastreatedwithSPSS12.0.Results:TheexaminationsofColorDopplerultrasoundwerepreformedpriortosurgeryand7daysafter.TheincidenceofLDVTwas16.66%(5)intheobserverGroup,10%(3)inthecontrolGroup(P0.05);Allindicatorsintwogroupsofblood,hemorheology:RBC,HCTdecreasedafteroperationinboth(P0.05);Comparedwiththepre-operation,bloodviscosity(Bv)andplasmaviscosity(Pv)decreased