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目的:探讨消瘀宽胸汤辅助胸腔闭式引流治疗创伤性血胸的临床疗效及对患者血液流动性、凝血功能的影响。方法:将76例患者随机按入院顺序分为对照组和观察组各38例。对照组采用以胸腔闭式引流为主的综合治疗措施。观察组在对照组治疗的基础上加用消瘀宽胸汤,1剂/d。两组疗程均为2周。记录两组引流量、引流时间、住院时间;随访观察凝固血胸和纤维胸的发生情况;检测凝血酶原时间(PT),活化部分凝血活酶时间(APTT),纤维蛋白原(FIB)和血浆D-二聚体测定(D-D),检测血液流变学指标,检测血栓素2(TXB2)及6-酮前列腺素F1α(6-Keto-PGF1α)水平,以上指标于治疗前及治疗后1周各检测1次。结果:经Ridit分析,观察组临床疗效优于对照组,差异有统计学意义(P<0.05);观察组引流量少于对照组,引流时间和住院时间均短于对照组(P<0.01);对照组凝固血胸或纤维胸的发生率为18.42%,观察组发生率为2.63%,观察组发生率低于对照组,但差异无统计学意义;治疗后1周,观察组D-D和FIB水平低于对照组(P<0.01),观察组血液流变学指标(全血黏度、血浆黏度、血沉、血小板聚集率、全血还原黏度)的改善优于对照组(P<0.01);治疗后1周,观察组TXB2水平低于对照组(P<0.01),6-Keto-PGF1α水平较高于对照组(P<0.01)。结论:消瘀宽胸汤减少了创伤性血胸患者的引流量,缩短了病程,并能改善血液循环,促进血液运行通畅,减少了凝固血胸或纤维胸的发生。
Objective: To investigate the clinical curative effect of Xiaoyu broad-minded soup-assisted thoracic drainage on the treatment of traumatic hemothorax and its influence on blood fluidity and coagulation function. Methods: 76 patients were randomly divided into control group and observation group according to the order of admission. The control group with thoracic closed drainage-based comprehensive treatment. Observation group in the control group based on the treatment plus Xiaoyu broad-minded soup, 1 / d. Two groups of treatment are 2 weeks. The drainage volume, drainage time and length of stay in the two groups were recorded. The occurrence of coagulation hemothorax and fibro-thoracic spine were observed. The serum levels of PT, APTT, fibrinogen (FIB) and fibrinogen The plasma D-dimer level (DD) was measured. The hemorrheological indexes were measured. The levels of TXB2 and 6-Keto-PGF1α were detected. The above indexes were measured before and after treatment Weekly test 1. Results: Ridit analysis showed that the clinical efficacy of the observation group was better than that of the control group (P <0.05). The drainage volume of the observation group was less than that of the control group, and drainage time and hospitalization time were shorter than those of the control group (P <0.01) ; Control group coagulation hematopoietic or fibrous chest incidence was 18.42%, the observation group incidence was 2.63%, the incidence of observation group was lower than the control group, but the difference was not statistically significant; 1 week after treatment, the observation group DD and FIB (P <0.01). The improvement of hemorrheological indexes (whole blood viscosity, plasma viscosity, erythrocyte sedimentation rate, platelet aggregation rate and whole blood reduction viscosity) in the observation group was better than that in the control group (P <0.01) After 1 week, TXB2 level in observation group was lower than that in control group (P <0.01), and 6-Keto-PGF1α level was higher than that in control group (P <0.01). Conclusion: Xiaoyu broad-minded soup can reduce the drainage of traumatic hemothorax, shorten the course of disease, improve blood circulation, promote the smooth operation of blood and reduce the occurrence of coagulation hemothorax or fibrosis.