方右旋糖酐40注射液联合甘露醇治疗下肢软组织开放性损伤负压封闭引流术后患者的疗效及对血液流变学的影响

目的:探讨复方右旋糖酐40注射液联合甘露醇治疗下肢软组织开放性损伤负压封闭引流(VSD)术后的治疗效果及对血液流变学的影响,为下肢软组织开放性损伤的治疗提供临床依据。方法:选取下肢软组织开放性损伤VSD术后患者80例,随机分为对照组和观察组各40例,对照组单纯应用甘露醇治疗,观察组应用复方右旋糖酐40注射液及甘露醇治疗,观察两组的临床疗效,比较两组治疗前后国际骨关节炎评分标准(Lequesne指数)、视觉模拟评分法(VAS)、美国食品药品管理局(FDA)皮肤评分、Lysholm膝关节功能评分(Lysholm)、血液流变学的变化以及不良反应发生情况。结果:治疗后,对照组和观察组的总有效率分别为85.00%、97.50%,比较差异具有统计学意义(P<0.05)。治疗后,两组VAS评分和Lequesne指数评分均降低,Lysholm评分及FDA皮肤评分较治疗前显著升高(P<0.05);治疗后,观察组VAS评分和Lequesne指数评分低于对照组,Lysholm评分及FDA皮肤评分高于对照组(P<0.05)。治疗后,两组血细胞比容较治疗前升高,全血比高切黏度、全血比低切黏度、血浆比黏度较治疗前降低(P<0.05);治疗后,观察组血细胞比容高于对照组,全血比高切黏度、全血比低切黏度、血浆比黏度低于对照组(P<0.05)。两组不良反应发生率比较无差异(P>0.05)。结论:复方右旋糖酐40注射液联合甘露醇治疗下肢软组织开放性损伤VSD术后患者疗效确切,可减轻膝关节疼痛,促进皮肤软组织恢复,改善膝关节功能和血液流变学,安全性较好。

The Therapeutic Effect of Compound Dextran 40 Injection Combined with Mannitol in the Treatment of Lower Extremity Soft Tissue Open Injury and the Influence on Hemorheology after Vacuum Sealing Drainage

ABSTRACT Objective: To explore the therapeutic effect of compound dextran 40 injection combined with mannitol in the treatment of lower extremity soft tissue open injury and the influence on hemorheology after vacuum sealing drainage (VSD), so as to provide clinical basis for the treatment of lower extremity soft tissue open injury. Methods: 80 patients with lower extremity soft tissue open injury after VSD were selected, randomly divided into control group and observation group 40 cases each, the control group was treated with mannitol alone, the observation group was treated with compound dxtran 40 injection combined mannitol, the clinical effects of the two groups were observed, the international osteoarthritis scoring standards(Lequesne index), visual analogue score (VAS score), Food and Drug Administration(FDA) skin score, Lysholm knee function score(Lysholm), hemorheology changes and adverse reactions were compared before and after treatment. Results: After treatment, the total effective rates of the control group and the observation group were 85.00%, 97.50% respectively, the difference between the two groups was statistically significant (P<0.05). After treatment, VAS score and Lequesne index score of the two groups were significantly lower than before treatment, Lysholm score and FDA skin score were significantly higher than before treatment (P<0.05). After treatment, VAS score and Lequesne index of the observation group were lower than those of the control group, Lysholm score and FDA skin score were higher than those of the control group (P< 0.05). After the treatment, the hematocrit of the two groups was higher than that before the treatment, the whole blood ratio high shear viscosity, the whole blood ratio low shear viscosity, the ratio of viscosity was lower than those before treatment (P<0.05). After the treatment, the hematocrit of the observation group was higher than that of the control group, the whole blood ratio high shear viscosity, the whole blood ratio low shear viscosity, the ratio of viscosity were lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Compound dextran 40 injection combined with mannitol is effective in the treatment of patients with lower extremity soft tissue open injury after VSD, it can alleviate knee pain, promote skin and soft tissue recovery, improve knee joint function and hemorheology, it is safe.