【摘要】：目的:觀察推拿療法在人工全髖關(guān)節(jié)置換術(shù)后早期預(yù)防下肢深靜脈血栓形成的療效,探討推拿療法對深靜脈血栓的作用機(jī)理,為臨床應(yīng)用提供依據(jù)。方法:選取2015年10月至2016年12月因非骨折疾病行單側(cè)全髖關(guān)節(jié)置換術(shù)患者60例,所有患者根據(jù)就診時間按隨機(jī)數(shù)表法隨機(jī)分為干預(yù)治療組(n=30)和基礎(chǔ)治療組(n=30),其中男性21例,女性39例,平均年齡(59.43±4.64)歲。分別予以下治療方案:(1)基礎(chǔ)治療組予常規(guī)治療:受試者手術(shù)均為同一組醫(yī)師完成,術(shù)中放置1條引流管,至常規(guī)術(shù)后24小時,不超過48小時,術(shù)后抗生素預(yù)防感染24小時,常規(guī)鎮(zhèn)痛、消腫處理,術(shù)后12小時開始口服利伐沙班片抗凝,10mg/d,療程5周,指導(dǎo)患者進(jìn)行常規(guī)功能鍛煉;(2)干預(yù)治療組:常規(guī)治療同時,于術(shù)后第1天開始,行雙下肢推拿手法治療,20min/次,2次/日,至術(shù)后2周。兩組觀察指標(biāo):1、靜脈血D-二聚體測定;2、術(shù)后疼痛評分(VAS評分);3、雙下肢彩色多普勒超聲檢查血栓形成;4、下肢乆靜脈血流的改變;5、術(shù)后大腿周徑測量。觀察并記錄兩組術(shù)前、術(shù)后各階段的相關(guān)評價指標(biāo),取得數(shù)據(jù),運(yùn)用SPSS軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果:(1)兩組一般資料差異無明顯統(tǒng)計(jì)學(xué)意義(P0.05),有可比性;(2)兩組術(shù)后比較:術(shù)后第1、4天,D-二聚體水平無明顯差異,無統(tǒng)計(jì)學(xué)意義,(P0.05),術(shù)后第7、10、14天,干預(yù)治療組D-二聚體水平較基礎(chǔ)治療組明顯降低,具有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后第1、14天VAS評分無明顯差異(P0.05),術(shù)后第4、7、10天VAS評分干預(yù)治療組較基礎(chǔ)治療組低,有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后第1天兩組受試者下肢深靜脈血栓形成率無明顯差異,不具有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后第7、14天,干預(yù)治療組下肢深靜脈血栓發(fā)生率較基礎(chǔ)治療組低,具有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后第1天兩組受試者雙下肢乆靜脈血流速度無明顯差異,不具有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后第7、14天,干預(yù)治療組雙下肢乆靜脈血流速度較基礎(chǔ)治療組高,有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后第1天兩組大腿周徑無明顯差異(P0.05),術(shù)后第4、7、14天干預(yù)治療組的大腿周徑較基礎(chǔ)治療組小,有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:推拿療法能有效的預(yù)防單側(cè)人工髖關(guān)節(jié)置換術(shù)后早期下肢深靜脈血栓的形成,并有助于術(shù)后早期下肢腫脹的消退。
[Abstract]:Objective: to observe the effect of massage therapy on the early prevention of deep vein thrombosis in lower extremity after total hip arthroplasty, to explore the mechanism of massage therapy on deep vein thrombosis, and to provide the basis for clinical application. Methods: from October 2015 to December 2016, 60 patients with unilateral total hip replacement due to non-fracture disease were randomly divided into two groups: intervention group (n = 30) and basic treatment group (n = 30). The average age of 39 female patients was (59.43 鹵4.64) years old. The following treatment schemes were given respectively: (1) routine treatment was given to the basic treatment group: the operation was performed by the same group of physicians, and a drainage tube was placed during the operation until 24 hours after the operation, no more than 48 hours, and 24 hours after the operation with antibiotics to prevent infection. Routine analgesia, detumescence treatment, oral administration of rivastaban tablet 10 mg / d at 12 hours after operation for 5 weeks to guide patients to perform routine functional exercises; (2) intervention group: routine treatment at the same time, beginning on the first day after operation, The patients were treated with massage manipulation for 20 min / d until 2 weeks after operation. The two groups were observed as follows: 1: 1, venous blood D-dimer 2, postoperative pain score (VAS) 3, lower extremity color Doppler ultrasound examination of thrombus formation 4, changes of venous blood flow in lower extremities 5, thigh circumference measured after operation. The relevant evaluation indexes were observed and recorded before and after operation in both groups. The data were obtained and analyzed by SPSS software. Results: (1) there was no significant difference in general data between the two groups (P0.05), and (2) comparison between the two groups: there was no significant difference in the level of D- dimer between the two groups on the 1st day after operation (P0.05), and there was no significant difference in the level of D- dimer between the two groups on the 1st day after operation (P0.05). The level of D- dimer in the intervention group was significantly lower than that in the basic treatment group (P0.05); there was no significant difference in VAS score on the 1th day after operation (P0.05); the VAS score of the intervention group was lower than that of the basic treatment group (P0.05) on the 4th day after operation (P0.05). On the first day after operation, there was no significant difference in the rate of deep venous thrombosis between the two groups (P0.05). On the 7th day after operation, the incidence of deep vein thrombosis in the intervention group was lower than that in the basic treatment group (P0.05). On the first day after operation, there was no significant difference in the velocity of venous flow between the two groups (P0.05). On the day 714 after operation, the velocity of venous blood flow in the intervention group was higher than that in the basic treatment group (P0.05). There was no significant difference in the thigh circumference between the two groups on the first day after operation (P0.05). The thigh circumference of the intervention group was smaller than that of the basic treatment group on the 4th and 14th day after operation (P0.05). Conclusion: massage therapy can effectively prevent the formation of early deep vein thrombosis after unilateral hip arthroplasty and is helpful to the early regression of lower extremity swelling.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 朱節(jié)云;推拿療法治療嗝逆32例體會[J];福建醫(yī)藥雜志;2001年02期

2 鄭巖;推拿療法治療落枕88例[J];實(shí)用中醫(yī)內(nèi)科雜志;2004年01期

3 劉學(xué)英,張杏芝,王全勇;推拿療法治療腹瀉62例[J];中國實(shí)用鄉(xiāng)村醫(yī)生雜志;2004年05期

4 楊禮淑;淺談如何提高推拿療法的治療效果[J];按摩與導(dǎo)引;2005年05期

5 陳士垣;;推拿療法在兒科臨床的應(yīng)用[J];南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版);1959年04期

6 趙明忠;;推拿療法治療小兒腹瀉[J];中醫(yī)雜志;1984年06期

7 于明芳,廖正烈;推拿療法在阿拉伯運(yùn)用舉隅[J];四川中醫(yī);1991年07期

8 王昭龍;;民間推拿療法中“八把半鎖”的探討[J];按摩與導(dǎo)引;1992年06期

9 趙仲和;推拿療法在治療面癱中的應(yīng)用[J];新疆中醫(yī)藥;1995年04期

10 臧建斌;推拿治療髖關(guān)節(jié)一過性滑膜炎32例[J];吉林中醫(yī)藥;1997年01期

相關(guān)會議論文 前10條

1 嚴(yán)金林;;倒懸推拿療法[A];中醫(yī)藥學(xué)術(shù)發(fā)展大會論文集[C];2005年

2 李雅;李娟;;學(xué)習(xí)小人推拿療法心得體會[A];第24屆全國中醫(yī)兒科學(xué)術(shù)研討會、中醫(yī)藥高等教育兒科教學(xué)研討會、兒科名中醫(yī)講習(xí)班論文匯編[C];2007年

3 李鎮(zhèn)峰;;推拿療法臨床舉隅[A];中國中醫(yī)藥學(xué)會基層中醫(yī)藥會議�？痆C];1997年

4 趙仲和;;溫和炙配合推拿療法治療顳頜關(guān)節(jié)功能紊亂[A];中國康復(fù)醫(yī)學(xué)會第二屆全國康復(fù)治療學(xué)術(shù)會議論文匯編[C];1999年

5 劉志新;;推拿治療小兒腹瀉172例[A];第25屆全國中醫(yī)兒科學(xué)術(shù)研討會暨中醫(yī)藥高等教育兒科教學(xué)研究會會議學(xué)術(shù)論文集[C];2008年

6 高天雪;;小兒三字經(jīng)推拿療法的臨床應(yīng)用[A];河南省中醫(yī)、中西醫(yī)結(jié)合護(hù)理暨中西醫(yī)骨傷護(hù)理研討觀摩交流會議論文集[C];2009年

7 馬慶華;;小兒捏脊推拿療法——綠色療法推廣[A];全國第13屆老年護(hù)理學(xué)術(shù)交流暨專題講座會議、全國中醫(yī)、中西醫(yī)結(jié)合護(hù)理學(xué)術(shù)交流暨專題講座會議論文匯編[C];2010年

8 王元元;劉曉鷹;王元新;;“扶中”推拿療法在小兒肺脾病證中的運(yùn)用初探[A];第28次全國中醫(yī)兒科學(xué)術(shù)大會暨2011年名老中醫(yī)治療（兒科）疑難病臨床經(jīng)驗(yàn)高級專修班論文匯編[C];2011年

9 孫麗萍;;兒童功能性便秘的家庭推拿療法研究[A];中華中醫(yī)藥學(xué)會肛腸分會換屆會議暨便秘專題研討會論文專刊[C];2007年

10 劉振寰;趙勇;羅冠君;李諾;招文健;;小兒腦性癱瘓中醫(yī)推拿療法的臨床應(yīng)用研究[A];中國針灸學(xué)會2009學(xué)術(shù)年會論文集（下集）[C];2009年

相關(guān)重要報(bào)紙文章 前5條

1 文波;高血壓病的自我推拿療法[N];保健時報(bào);2006年

2 容容;頸椎病的按摩、推拿療法[N];醫(yī)藥經(jīng)濟(jì)報(bào);2003年

3 周偉;三大“職業(yè)病”的家庭推拿療法[N];中國中醫(yī)藥報(bào);2007年

4 本報(bào)記者 劉克雄 見習(xí)記者 劉佳 劉媛媛;倒懸推拿，破解治療難題[N];黃石日報(bào);2006年

5 馬麗麗;回族民間針灸推拿療法[N];農(nóng)村醫(yī)藥報(bào)（漢）;2006年

相關(guān)碩士學(xué)位論文 前7條

1 李曉麗;《內(nèi)經(jīng)》推拿療法的理論研究[D];山東中醫(yī)藥大學(xué);2015年

2 邱顏昭;推拿療法治療小兒輪狀病毒腸炎的臨床研究[D];南京中醫(yī)藥大學(xué);2011年

3 朱慧;推拿療法治療小兒急性腹瀉的臨床研究[D];南京中醫(yī)藥大學(xué);2012年

4 嚴(yán)偉;運(yùn)脾化濕清腸推拿療法治療小兒濕熱泄瀉的臨床研究[D];南京中醫(yī)藥大學(xué);2005年

5 魏娟;推拿療法合強(qiáng)志散治療小兒多發(fā)性抽動癥（腎志不足證）的臨床觀察[D];山東中醫(yī)藥大學(xué);2015年

6 趙吉忠;推拿治療小兒感染后脾虛綜合征的臨床觀察[D];山東中醫(yī)藥大學(xué);2005年

7 林彩霞;推拿對軟組織損傷兔β-EP、5-HT含量及組織病理學(xué)影響的研究[D];北京中醫(yī)藥大學(xué);2006年

，

本文編號：2228917