血府逐瘀汤联合胸腔镜手术治疗创伤性血气胸的临床疗效及对应激反应和凝血功能的影响OACSTPCD
Clinical effect of Xuefu Zhuyu decoction combined with thoracoscopic surgery on traumatic hemopneumothorax and its influence on stress response and coagulation function
目的:探讨血府逐瘀汤联合胸腔镜手术治疗创伤性血气胸的临床疗效及对应激反应和凝血功能的影响.方法:将72例创伤性血气胸患者按照随机数字表法分为对照组和观察组,各36例.对照组采用胸腔镜进行手术并给予机械通气,观察组在对照组基础上联合血府逐瘀汤进行治疗.比较两组临床治疗总有效率、气滞血瘀症状评分、肺功能指标[第1秒用力呼气量(FEV1)、肺活量(VC)、最大通气量(MVV)、用力肺活量(FVC)]、应激反应指标[皮质醇(Cor)、去甲肾上腺素(NE)、胰岛素(Ins)、血管紧张素Ⅱ(AT-Ⅱ)]、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和D-二聚体(D-D)],以及术后并发症发生率.结果:观察组患者临床治疗总有效率为97.22％,高于对照组的83.33％,有统计学意义(P＜0.05);治疗后,对照组及观察组患者气滞血瘀症状评分、Cor、NE、Ins、AT-Ⅱ、FIB水平均降低,FEV1、VC、MVV、FVC、PT、APTT、TT和D-D均升高,有统计学意义(P＜0.05);与对照组比较,观察组患者气滞血瘀症状评分、Cor、NE、Ins、AT-Ⅱ、FIB水平均降低,FEV1、VC、MVV和FVC显著升高,有统计学意义(P＜0.05).结论:血府逐瘀汤联合胸腔镜手术治疗创伤性血气胸效果理想,可显著改善患者肺功能和凝血功能,减少应激反应.
Objective To investigate the clinical effect of Xuefu Zhuyu decoction combined with thoracoscopic surgery on traumatic hemopneumothorax and its influence on stress reaction and blood coagulation function.Methods Seventy two patients with traumatic hemopneumothorax were randomly divided into the control group and the observation group according to the random number table.36 patients in the control group were treated with thoracoscopic surgery and mechanical ventilation.36 patients in the observation group were treated with Xuefu Zhuyu decoction on the basis of the control group.The total effective rate of clinical treatment was compared.The scores of qi stagnation and blood stasis symptoms,lung function indexes[FEV1,VC,MVV,FVC],stress response indexes[cortisol(Cor),norepinephrine(NE),insulin(Ins),angiotensin Ⅱ(AT-Ⅱ)]Coagulation function indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and D-dimer(D-D)],the incidence of postoperative complications was compared between the two groups.Results The total effective rate of the observation group was 97.22％,which was higher than that of the control group 83.33％,the difference was statistically significant(P＜0.05).After treatment,the scores of qi stagnation and blood stasis symptoms,the levels of Cor,NE,Ins,AT-Ⅱ and FIB in the control group and the observation group decreased,and FEV1,VC,MVV,FVC,PT,APTT,TT and D-D increased,the difference was statistically significant(P＜0.05).Compared with the control group,the scores of symptoms of qi stagnation and blood stasis,the levels of Cor,NE,Ins,AT-Ⅱ and FIB in the observation group decreased,FEV1,VC,MVV and FVC significantly increased,the difference was statistically significant(P＜0.05).Conclusion Xuefu Zhuyu decoction combined with thoracoscopic surgery has an ideal effect in the treatment of traumatic hemopneumothorax.It could significantly improve the pulmonary function and blood coagulation function of patients,reduce stress reaction,and reduce the risk of complications.
于涛;齐拥军;张秋生;付景伟;周世杰
北京市门头沟区医院胸外科(北京 102300)北京胸科医院胸外科(北京 101125)
临床医学
血府逐瘀汤胸腔镜手术创伤性血气胸应激反应凝血功能
Xuefu Zhuyu decoctionthoracoscopic surgerytraumatic hemopneumothoraxstress reactioncoagulation function
《中国中西医结合外科杂志》 2024 (002)
243-247 / 5
北京市医院管理中心文件(XMLX202124)
评论