八珍汤治疗单节段腰椎退行性疾病开放TLIF手术围手术期隐性失血疗效观察

Effect of Bazhen Decoction on Recessive Blood Loss during Perioperative Period of Open TLIF Operation for Single-Level Lumbar Degenerative Diseases

摘要: 目的：观察八珍汤治疗单节段腰椎退行性疾病开放TLIF (transforaminal lumbar interbody fusion, TLIF)手术围手术期隐性失血疗效。方法：接受开放TLIF手术治疗的单节段腰椎退行性病变患者七十例被纳入研究，并通过随机的数字表法区分为使用八珍汤的组(35例)、不服用中药的对照组(35例)。临床评价包括血红蛋白、总失血量、显性失血量、隐性失血量、腰痛VAS (visual analog score, VAS)评分、下肢痛VAS评分、腰椎JOA (Japanese Orthopedic Association, JOA)评分，结果：治疗组患者的总失血量、显性失血量、隐性失血量、术前术后血红蛋白丢失均小于对照组(P < 0.05)，治疗组患者术后腰痛VAS评分、术后下肢痛VAS评分、术后腰椎JOA评分均优于对照组(P < 0.05)。结论：单节段腰椎退行性疾病开放TLIF手术后予患者服用八珍汤，能在一定程度上减少患者总失血量、显性失血量、隐性失血量，加速术后康复，提升生存质量。

Abstract: Objective: To observe the efficacy of Bazhen Decoction in the treatment of recessive blood loss during perioperative period after open TLIF (transforaminal lumbar interbody fusion, TLIF) operation for single-level lumbar degenerative diseases. Methods: Seventy patients with single-level lumbar degenerative disease who underwent open TLIF surgery were enrolled and randomly divided into bazhen Decoction group (35 cases) and control group (35 cases) by number table. Clinical evaluation included hemoglobin, total blood loss, dominant blood loss, recessive blood loss, lumbar VAS (visual analog score, VAS) score, lower limb VAS score, and lumbar JOA (Japanese Orthopedic Association, JOA) score. Results: Total blood loss, dominant blood loss, recessive blood loss, and preoperative and postoperative hemoglobin loss in the treatment group were all lower than those in the control group (P < 0.05). Postoperative lumbar VAS score, postoperative lower limb VAS score and postoperative lumbar JOA score in the treatment group were better than those in the control group (P < 0.05). Conclusion: Bazhen Decoction can reduce total blood loss, dominant blood loss and recessive blood loss in patients with single-level lumbar degenerative disease after TLIF operation to a certain extent, and accelerate postoperative recovery, improve the quality of life.