摘要
目的观察自拟舒筋活血汤辅助关节镜下胫骨高位截骨术的临床效果。方法回顾性分析2019年1月至2020年6月在骨科行关节镜辅助胫骨高位截骨术的84例患者的临床资料,随机分为试验组及对照组(各42例)。其中试验组脱落2例,对照组脱落2例,最终两组完成试验者各40例。两组患者均实施关节镜辅助胫骨内侧开放高位楔形截骨、胫骨近端内侧“T”加压锁定钢板内固定术治疗,试验组在此基础上于术后第1天开始服用舒筋活血汤,3次/d,共14 d。分别在术后3 d、1个月和3个月评估两组疼痛改善情况、膝关节功能及术后并发症发生情况。结果试验组手术优良率(90.00%)高于对照组(70.00%)(P=0.025)。两组患者在手术时间、术中出血量方面差异无统计学意义(P>0.05)。试验组患者住院时间短于对照组(P<0.05)。两组术前VAS评分相比差异无统计学意义(P>0.05),术后3 d、术后1个月及术后3个月时间点VAS评分逐步下降,试验组VAS评分低于对照组(P<0.05)。两组术前血清D-二聚体(D-D)、超敏C反应蛋白(hs-CRP)水平相比差异无统计学意义(P>0.05)。两组术后3个月D-D、hs-CRP水平均降低,试验组低于对照组(P<0.05)。两组术前HSS评分相比差异无统计学意义(P>0.05);两组术后3 d、术后1个月及术后3个月时间点HSS评分逐步升高,试验组HSS评分高于对照组(P<0.05)。两组均未发感染、异位骨化、截骨处再骨折,也未有再手术情况的发生;试验组下肢深静脉血栓发生率为5.00%,显著低于对照组(17.50%)(P<0.05)。结论将自拟方舒筋活血汤用于关节镜辅助胫骨高位截骨术围手术期疗效显著,能有效缓解膝关节炎患者术后疼痛症状,促进膝关节功能的恢复,减轻机体炎症反应,改善血液流变学,并能降低并发症的发生。
Objective To observe the clinical effects of a self-formulated Shu Jin Huo Xue Tang as an adjunct to arthroscopic tibial tuberosity osteotomy.Methods A retrospective analysis was conducted on the clinical data of 84 patients who underwent arthroscopic-assisted tibial tuberosity osteotomy in orthopedic department from January 2019 to June 2020.The patients were randomly divided into an experimental group and a control group,with 42 cases in each.Two cases dropped out from each group,leaving a final completion of 40 cases in each group.Both groups underwent arthroscopic-assisted medial open-wedge tibial osteotomy with proximal medial"T"compression locking plate fixation.The experimental group started taking Shu Jin Huo Xue Tang from the first day after surgery,three times a day,for a total of 14 days.Pain improvement,knee joint function,and postoperative complications were assessed on postoperative days 3,1 month,and 3 months.Results The excellent rate of surgery in the experimental group(90.00%)was higher than that in the control group(70.00%)(P=0.025).There was no statistically significant difference in surgical time and intraoperative blood loss between the two groups(P>0.05).The length of hospital stay in the experimental group was shorter than that in the control group(P<0.05).There was no statistically significant difference in preoperative VAS scores between the two groups(P>0.05).The VAS scores gradually decreased at postoperative day 3,1 month,and 3 months,with the experimental group having lower VAS scores than the control group(P<0.05).There was no significant difference in preoperative serum D-dimer(D-D)and high-sensitivity C-reactive protein(hs-CRP)levels between the two groups(P>0.05).The levels of D-D and hs-CRP in both groups decreased at 3 months postoperatively,with the experimental group being lower than the control group(P<0.05).There was no statistically significant difference in preoperative HSS scores between the two groups(P>0.05).The HSS scores gradually increased at postoperative day 3,1 m
作者
黄永华
李书良
王玉玺
HUANG Yong-hua;LI Shu-liang;WANG Yu-xi(Department of Orthopedics,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,Henan,China)
出处
《广东医学》
CAS
2024年第1期106-110,共5页
Guangdong Medical Journal
基金
河南省中医药科学研究专项项目(20-21ZY2300)。
关键词
舒筋活血汤
膝关节炎
胫骨高位截骨术
加速康复
Shu Jin Huo Xue Tang
knee arthritis
tibial tuberosity osteotomy
accelerated rehabilitation
