复元活血汤联合西药预防麦默通手术出血的疗效及对患者术后疼痛的影响
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摘要
目的探讨复元活血汤联合西药预防麦默通手术出血的临床疗效,以及对患者术后疼痛的影响。方法选取2016年6月—2017年10月期间在温州市中医院行麦默通乳腺结节微创旋切术的80例女性患者为研究对象,根据简单随机化分组方式(1∶1)将其分为对照组和观察组,每组各40例。对照组给予弹力绷带加压包扎48 h处理和止血药静滴等常规干预,观察组在对照组基础上,术前3 d联合复元活血汤预防治疗。比较2组手术时间、术中出血量、住院时间和费用等基本情况,观察术后疼痛视觉模拟评分(VAS)和相关并发症发生情况。结果 2组患者均成功完成手术,无中途退出病例。观察组手术出血量[(5. 1±1. 5)ml]、住院天数[(2. 1±1. 6)d]、住院费用[(8 970. 2±921. 3)元]分别较对照组低[出血量(6. 8±1. 7)ml、住院天数(4. 1±1. 1)d、(9 452. 6±845. 2)元],差异具有统计学意义(均P <0. 05);观察组术后血肿发生率为2. 50%(1/40),显著低于对照组的22. 50%(9/40),差异具有统计学意义(P <0. 05);观察组术后2、3 d的VAS评分[(3. 2±1. 0)分、(2. 5±0. 9)分]分别比对照组低[(3. 8±1. 2)分、(3. 1±1. 1)分],差异具有统计学意义(P <0. 05)。结论复元活血汤有助于减少麦默通手术出血和降低血肿并发症风险,减轻患者生理疼痛和住院费用,临床应用价值显著。
Objective To investigate the effect of Fuyuan Huoxue Decoction Combined with western medicine on preventing hemorrhage after mammotome operation and its effect on postoperative pain,so as to improve the clinical effect of benign breast swelling. Methods In this study,80 women with mammotome breast nodules in our hospital during the period of June,2016 to October,2017 were selected as the subjects. According to the simple randomization group(1∶ 1),they were divided into the control group and the observation group,and the two groups were 40 cases each. The control group was given the elastic bandage pressure thin wrapping 48 h treatment and the static drip of hemostatic medicine. On the basis of the control group,the observation group was treated with 3 D combined with Fuyuan Huoxue Decoction. The operation time,the amount of bleeding,the time of hospitalization and the cost of the two groups were compared,and the postoperative pain visual analogue score( VAS) and the related complications were observed. Results Two groups of patients were successfully completed surgery,no withdrawal case. The amount of operation bleeding [(5. 1 ± 1. 5) ml],hospital days [(3. 4 ± 1. 3) days] and hospitalization expenses [(8 970. 2 ± 921. 3) yuan] were lower than that of the control group [(6. 8 ± 1. 7) ml],hospitalization days [(4. 1 ± 1. 1) days] and [(9 452. 6 ± 845. 2) yuan],and the difference was statistically significant( P < 0. 05). The postoperative hematoma rate 2. 50%( 1/40) was significantly lower in the observation group. The difference was statistically significant in the control group 22. 50%(9/40),and the difference was statistically significant( P < 0. 05). The VAS scores of 2 D and 3 D [(3. 2 ± 1. 0) and(2. 5 ± 0. 9)] in the observation group were lower than those of the control group [(3. 8 ± 1. 2) and(3. 1 ± 1. 1)]respectively,and the difference was statistically significant( P < 0. 05). Conclusion Fuyuan Huoxue Decoction can help reduce the risk of bleeding and complication of hematoma,reduce the patient's physical pain and hospitalization expenses,and the clinical application value is remarkable.
Objective To investigate the effect of Fuyuan Huoxue Decoction Combined with western medicine on preventing hemorrhage after mammotome operation and its effect on postoperative pain,so as to improve the clinical effect of benign breast swelling. Methods In this study,80 women with mammotome breast nodules in our hospital during the period of June,2016 to October,2017 were selected as the subjects. According to the simple randomization group(1∶ 1),they were divided into the control group and the observation group,and the two groups were 40 cases each. The control group was given the elastic bandage pressure thin wrapping 48 h treatment and the static drip of hemostatic medicine. On the basis of the control group,the observation group was treated with 3 D combined with Fuyuan Huoxue Decoction. The operation time,the amount of bleeding,the time of hospitalization and the cost of the two groups were compared,and the postoperative pain visual analogue score( VAS) and the related complications were observed. Results Two groups of patients were successfully completed surgery,no withdrawal case. The amount of operation bleeding [(5. 1 ± 1. 5) ml],hospital days [(3. 4 ± 1. 3) days] and hospitalization expenses [(8 970. 2 ± 921. 3) yuan] were lower than that of the control group [(6. 8 ± 1. 7) ml],hospitalization days [(4. 1 ± 1. 1) days] and [(9 452. 6 ± 845. 2) yuan],and the difference was statistically significant( P < 0. 05). The postoperative hematoma rate 2. 50%( 1/40) was significantly lower in the observation group. The difference was statistically significant in the control group 22. 50%(9/40),and the difference was statistically significant( P < 0. 05). The VAS scores of 2 D and 3 D [(3. 2 ± 1. 0) and(2. 5 ± 0. 9)] in the observation group were lower than those of the control group [(3. 8 ± 1. 2) and(3. 1 ± 1. 1)]respectively,and the difference was statistically significant( P < 0. 05). Conclusion Fuyuan Huoxue Decoction can help reduce the risk of bleeding and complication of hematoma,reduce the patient's physical pain and hospitalization expenses,and the clinical application value is remarkable.
引文
[1]董华英,汤鹏,钟晓捷,等.超声引导下麦默通真空辅助抽吸旋切系统在乳腺肿物诊治中的应用:附1 157例报告[J].中国普通外科杂志,2015,24(5):677-682.
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[10]陆丹尔,方晔,陆爱美,等.超声引导下麦默通手术治疗乳腺良性肿瘤的效果及术后放置留置针的意义[J].现代实用医学,2017,29(11):1414-1416.
[11]崔潇洋.改良麦默通微创术治疗乳腺肿块的临床效果[J].中国当代医药,2017,24(34):116-118.
[12]朱婧,朱大江,范旭龙,等.乳腺良性叶状肿瘤复发相关危险因素及麦默通手术的可行性[J].分子影像学杂志,2017,40(4):449-452.
[13]王新刚.麦默通手术切除乳腺良性肿块的效果[J].中国民康医学,2018,30(1):32-33.
[14]张玉泽.乳腺微创手术(麦默通手术)在乳腺瘤切除的临床应用[J].世界最新医学信息文摘,2016,16(77):87-88.
[15]黄传蔷,姚成才,陈庞洲,等.麦默通联合高负压引流在治疗乳腺脓肿中的应用[J].白求恩医学杂志,2017,15(1):106-108.
[16]陈军.麦默通手术治疗良性乳腺肿块的临床应用价值探讨[J].医学理论与实践,2017,30(8):1168-1169.
[17]汪磊,季晓春,丁锦华,等.超声引导下麦默通旋切装置治疗较大乳腺良性肿块的临床研究[J].中国现代医生,2017,55(9):75-77,81.
[18]齐久梅,王钢乐,唐欣,等.麦默通微创旋切术与传统切开手术在乳腺肿物治疗中的对比研究[J].中国医学装备,2015,12(9):86-89.
[19]黎新仲,李毅,张雪霞,等.超声引导下麦默通微创手术切除乳腺良性肿瘤的疗效分析[J].吉林医学,2016,37(1):157-158.
[20]王健,张丽娜,顾林.麦默通在乳腺良性肿块治疗中的应用研究[J].天津医药,2016,44(4):385-388.
[2]那将超,狄长安,殷咏梅,等.麦默通微创旋切术与传统手术治疗乳腺肿块效果对比分析[J].临床和实验医学杂志,2015,15(6):435-438.
[3]王春霞,华健,张瑞东,等.复元活血汤加减治疗血瘀型糖尿病前期患者的临床疗效观察[J].中国中医药科技,2017,24(4):473-475.
[4]杨波,唐诗,袁月欢,等.超声引导下麦默通旋切术切除较大良性乳腺肿块的临床研究[J].中国普通外科杂志,2015,24(5):683-686.
[5]邵超,张晶晶,凌飞海,等.经乳晕切口治疗乳腺良性疾病中麦默通微创旋切系统与传统手术的临床效果对比[J].实用医学杂志,2015,20(7):1142-1144.
[6]吴贤,娄朝胜,施仲义,等.复元活血汤预防麦默通手术出血并发症的临床观察[J].中国中医药科技,2017,24(5):649-650.
[7]石坤和,高瑛,顾渊,等.大柴胡汤加味治疗老年急性胆囊炎临床观察[J].中国中医急症,2015,24(7):1225-1226.
[8]马志伟,孙波,王敏,等.掌侧微创切口加Herbert螺钉联合复元活血汤治疗腕舟状骨骨折临床观察[J].中国中医急症,2015,24(2):351-353.
[9]罗正广.复元活血汤联合丹参注射液应用于骨科急性创伤疼痛30例[J].河南中医,2015,35(6):1321-1322.
[10]陆丹尔,方晔,陆爱美,等.超声引导下麦默通手术治疗乳腺良性肿瘤的效果及术后放置留置针的意义[J].现代实用医学,2017,29(11):1414-1416.
[11]崔潇洋.改良麦默通微创术治疗乳腺肿块的临床效果[J].中国当代医药,2017,24(34):116-118.
[12]朱婧,朱大江,范旭龙,等.乳腺良性叶状肿瘤复发相关危险因素及麦默通手术的可行性[J].分子影像学杂志,2017,40(4):449-452.
[13]王新刚.麦默通手术切除乳腺良性肿块的效果[J].中国民康医学,2018,30(1):32-33.
[14]张玉泽.乳腺微创手术(麦默通手术)在乳腺瘤切除的临床应用[J].世界最新医学信息文摘,2016,16(77):87-88.
[15]黄传蔷,姚成才,陈庞洲,等.麦默通联合高负压引流在治疗乳腺脓肿中的应用[J].白求恩医学杂志,2017,15(1):106-108.
[16]陈军.麦默通手术治疗良性乳腺肿块的临床应用价值探讨[J].医学理论与实践,2017,30(8):1168-1169.
[17]汪磊,季晓春,丁锦华,等.超声引导下麦默通旋切装置治疗较大乳腺良性肿块的临床研究[J].中国现代医生,2017,55(9):75-77,81.
[18]齐久梅,王钢乐,唐欣,等.麦默通微创旋切术与传统切开手术在乳腺肿物治疗中的对比研究[J].中国医学装备,2015,12(9):86-89.
[19]黎新仲,李毅,张雪霞,等.超声引导下麦默通微创手术切除乳腺良性肿瘤的疗效分析[J].吉林医学,2016,37(1):157-158.
[20]王健,张丽娜,顾林.麦默通在乳腺良性肿块治疗中的应用研究[J].天津医药,2016,44(4):385-388.