耳穴压籽联合低频电穴位刺激对髋、 膝关节术后深静脉血栓形成预防效果观察

Effect of auricular point pressure seed combined with low frequency electric acupuncture point stimulation on prevention of deep vein thrombosis after hip and knee surgery

关键词:  耳穴压籽  低频电穴位刺激  髋、膝关节术  深静脉血栓

Key words:  auricular point pressure seed  low frequency electric point stimulation  hip and knee surgery  deep vein thrombosis

摘要:

[目的] 观察耳穴压籽联合低频电穴位刺激对髋、膝关节术后深静脉血栓（DVT）形成预防效果。[方法] 选定天津中医药大学第二附属医院2018年8月—2023年8月就诊的120例髋、膝关节手术患者，以随机数字表法随机将其分为2组，各60例，对照组给予利伐沙班治疗，观察组在对照组的基础上给予低频电穴位刺激联合耳穴压籽治疗，两组均在治疗7 d后进行疗效评价，比较两组血栓弹力图（TEG）参数、凝血功能指标、患肢周径差值、患肢肿胀程度、视觉模拟自评量表（VAS）评分、DVT发生率。[结果] 观察组治疗后凝血指数（CI）、最大振幅（MA）、血凝块聚合形成速率（α角）均低于对照组，差异有统计学意义（P＜0.05），观察组治疗后凝血时间（K）、反应时间（R）均高于对照组，差异有统计学意义（P＜0.05）。观察组治疗后D-二聚体（D-D）、纤维蛋白原（FIB）均低于对照组，差异有统计学意义（P＜0.05），观察组治疗后部分凝血酶原时间（APTT）、凝血酶原时间（PT）均高于对照组，差异有统计学意义（P＜0.05）。观察组治疗后大腿、小腿周径差值均低于对照组，差异有统计学意义（P＜0.05）。观察组患肢肿胀程度轻于对照组，差异有统计学意义（P＜0.05）。观察组治疗后VAS评分低于对照组，差异有统计学意义（P＜0.05）。观察组DVT发生率（1.67%）低于对照组（13.33%），差异有统计学意义（P＜0.05）。[结论] 耳穴压籽联合低频电穴位刺激可有效改善髋、膝关节手术患者术后凝血功能，缓解肢体肿胀、疼痛等症状，缩小患肢周径差，降低DVT发生率。

Abstract:

[Objective] To analyze the preventive effect of auricular point pressure seed combined with low-frequency electric acupuncture point stimulation on the formation of deep vein thrombosis （DVT） after hip and knee surgery. [Methods] The 120 patients who underwent hip and knee surgery at the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from August 2018 to August 2023 were selected and randomly divided into two groups using a random number table method，with 60 patients in each group. The control group received treatment with rivaroxaban，while the observation group received low-frequency electrical acupointstimulation combined with ear acupoint seed pressing treatment on the basis of the control group. The therapeutic effects of both groups were evaluated 7 days after treatment. The thromboelastography （TEG） parameters，coagulation function indicators，difference in limb circumference，degree of limb swelling，visual analogue self-assessment scale （VAS） scores，and incidence of DVT were compared between the two groups. [Results] The coagulation index （CI），maximum amplitude （MA），and rate of blood clot aggregation aftert reatment（α angle） of the observation group were lower than those of the control group after treatment（P<0.05）. The coagulation time（K） and reaction time （R） of the observation group were higher than those of the control group after treatment，and the difference was statistically significant（P<0.05）. After treatment，the levels of D-dimer（D-D） and fibrinogen（FIB） in the observation group were lower than those in the control group，with statistical significance（P<0.05）. The partial prothrombin time（APTT） and prothrombin time（PT） in the observation group were higher than those in the control group，with statistical significance （P<0.05）. The difference in circumference of the thighs and calves in the observation group after treatment was lower than that in the control group，and the difference was statistically significant （P<0.05）. The degree of swelling in the affected limbs of the observation group was milder than that of the control group，and the difference was statistically significant（P<0.05）. The VAS score of the observation group after treatment was lower than that of the control group，and the difference was statistically significant（P<0.05）. The incidence of DVT in the observation group（1.67%） was lower than that in the control group （13.33%），and the difference was statistically significant （P<0.05）. [Conclusion] Auricular point pressure seed combined with low-frequency electric acupuncture point stimulation can effectively improve the coagulation function of the patients with hip and knee surgery，relieve the symptoms of limb swelling and pain，narrow the circumference difference of the affected limb，and reduce the incidence of DVT.