血府逐瘀汤治疗肋骨骨折并发症分层对照临床研究

作者	单位
祝涛	上海中医药大学附属曙光医院创伤急救中心
胡宗德	上海中医药大学附属曙光医院创伤急救中心
麦静愔	上海中医药大学附属曙光医院创伤急救中心

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中文摘要:

目的探讨血府逐瘀汤治疗肋骨骨折并发症的临床效果。方法 120例钝性胸部损伤合并肋骨骨折胸部简明损伤分级(abbreviated injury scale,AIS)1～3分的患者,根据胸部AIS分值分为3层,每层分为对照组及治疗组,每组20例。两组均采用常规治疗法,治疗组加用血府逐瘀汤。比较两组患者肺不张、胸腔积液、肺挫伤发生率及需行胸腔穿刺或胸腔闭式引流率等。结果治疗组胸部AIS为1、2分的患者中胸腔积液发生率分别为20%、45%,低于对照组的55%、85%,胸部AIS为3分的患者中胸腔闭式引流率为10%,低于对照组的60%,差异有统计学意义(P<0.05)。结论血府逐瘀汤能显著降低AIS1、2分的肋骨骨折患者胸腔积液发生率及AIS3分肋骨骨折患者胸腔闭式引流率,有临床应用价值。

英文摘要:

Objective To evaluate the clinical effect of Xuefu Zhuyu Decoction(XFZYD) on the incidence of complications of rib fracture in patients with blunt chest injury.Methods One hundred and twenty patients with rib fracture stratified according to the AIS scale in three layers(1-3) were equally assigned to two groups,the treated group and the control group,all received conventional treatment,but XFZYD was administered to patients in the treated group additionally.The incidence of complications in patients,including atelectasis, pleural effusion,pulmonary contusion,pleurocentesis and closed thoracic drainage,were observed.Results The incidence of pleural effusion in patients of AIS-1 and -2 in the treated group was 20%and 45%respectively, which was remarkable lower than that in the control group(55%and 85%) respectively(P<0.05);in the treated group,10%patients of AIS-3,for whom close thoracic drainage was applied,while in the control group,the percentage reached 60%,showing significant difference between groups(P<0.05).Conclusion XFZYD could reduce the incidence of pleural effusion in patients with blunt chest injured rib fracture of AIS-1 or -2,and reduce the utilization of close thoracic drainage in those of AIS-3,so it is good for clinical practice.

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