摘要
[目的]观察五味消毒饮联合闭式灌洗引流术治疗腰椎内固定术后早期感染(气滞血瘀)疗效。[方法]使用随机平行对照方法,将60例住院患者按随机数字表法随机分两组。对照组30例麻醉下行病灶切开清创置管闭式灌洗引流,手术清创过程中应将脓性分泌物或坏死组织彻底清除,保留内固定装置,病灶清理后用双氧水及生理盐水反复冲洗,医用无醇安尔碘液浸泡数分钟后,生理盐水冲洗病灶,术后根据细菌培养结果选用敏感抗生素配于冲洗液中进行持续灌洗引流。维持负压引流3~5d。治疗组30例五味消毒饮(金银花、野菊花、紫花地丁、冬葵子、蒲公英各10g,肿胀明显加泽泻10g,茯苓15g;肿痛明显加虎杖10g;皮温高加生地、丹皮各10g);1剂/d,水煎500mL,早晚口服;西医治疗同对照组。连续治疗7d为1疗程。观测临床表现、抗生素使用时间、感染治愈时间、创口边缘上皮组织覆盖愈合时间、不良反应。治疗1疗程,判定疗效。[结果]治疗组显效12例,有效16例,无效2例,总有效率93. 33%;对照组显效8例,有效12例,无效10例,总有效率66. 67%;治疗组疗效优于对照组(P <0. 05)。抗生素使用时间、感染治愈时间、创口边缘上皮组织覆盖愈合时间治疗组均优于对照组(P <0. 01)。[结论]五味消毒饮联合闭式灌洗引流术治疗腰椎内固定术后早期感染(气滞血瘀),疗效满意,无严重不良反应,值得推广。
[Objective] To investigate the effect of Wuwei Xiaodun Yin combined with closed lavage and drainage on early infection( Qi stagnation and blood stasis) patients with lumbar internal fixation.[Methods]Sixty inpatients were randomly divided into two groups according to the random number table method.Control group( 30 cases) was treated with lesions debridement catheter closed lavage drainage after anesthesia. The surgical debridement or necrotic tissue purulent secretion should be thoroughly removed,keeping the internal fixation device. After cleaning up,we repeatedly washed the lesions with hydrogen peroxide solution and physiological saline. After no alcohol based medical iodine solution soak for a few minutes,saline was used for flushing lesions. According to the results of bacterial culture,we chose sensitive antibiotic for continuous irrigation drainage in the lotion. The negative pressure drainage was maintained for 3-5 d. In the treatment group,30 patients were treated with Wuwei Xiaodun Yin[Jinyinhua( honeysuckle) 10 g,Yejuhua( wild chrysanthemum) 10 g,Zihua Diding( purple flower) 10 g,Dongkuizi( anemone seed) 10 g,Pugongying( dandelion) 10 g. If there was obvious swelling,Zexie( alisma) 10 g and Fuling( poria cocos) 15 g were added. If there was swelling and pain,Huzhang( polygonum cuspidatum) 10 g was added. If there was high skin temperature,Shengdi( dried rhizome of rehmannia) 10 g and Danpi( tree peony bark) 10 g],1 dose/d,decocted in 500 mL water,taken orally in the morning and evening. Western medicine was the same as the control group. Continuous treatment for 7 days was a course of treatment. Clinical manifestations,antibiotic use time,infection healing time,wound edge epithelial tissue cover healing time,and adverse reactions were observed. After treatment 1 course,the curative effect was judged.[Results] In the treatment group,there were 12 significant cases,16 effective cases and 2 ineffective cases,and the total effective rate was 93. 33%. In the control group,8 cases showed significant effect,
作者
赵思婷
冯永洪
李真
王新强
ZHAO Siting;FENG Yonghong;LI Zhen;WANG Xinqiang(Intravenous Drug Dispatching Center, Dongguan Traditional Chinese Medicine Hospital, Dongguan 523600 , Guangdon , China;Orthopaedic Surgery , Dongguan Traditional Chinese Medicine Hospital, Dongguan 523600 , Guangdon , China)
出处
《实用中医内科杂志》
2019年第6期20-23,共4页
Journal of Practical Traditional Chinese Internal Medicine
基金
东莞市科技一般项目(201850715002313)~~
关键词
腰椎内固定术后早期感染
气滞血瘀
闭式灌洗引流术
五味消毒饮
抗生素使用时间
感染治愈时间
创口边缘上皮组织覆盖愈合时间
中药复方
中西医结合治疗
随机平行对照研究
early infection after lumbar internal fixation
Qi stagnation and blood stasis
closed lavage and drainage
Wuwei Xiaodun Yin
duration of antibiotic use
infection healing time
healing time of epithelial tissue covering the wound edge
Chinese herbal compound
integrated traditional Chinese and western medicine
randomized parallel control study
