桃红四物汤配合PFNA治疗老年骨质疏松性股骨粗隆间骨折23例

Taohong Siwu Decoction combined with PFNA in the Treatment of Elderly Intertrochanteric Fracture for 23 Cases

目的探讨桃红四物汤配合防旋型股骨近端髓内钉(PFNA)治疗老年骨质疏松性股骨粗隆间骨折的临床疗效及安全性。方法回顾性分析2013年1月—2014年1月收治PFNA治疗老年骨质疏松性股骨粗隆间骨折患者45例,随机分为对照组(22例)和观察组(23例)。对照组采取常规治疗,观察组在常规治疗的基础上使用桃红四物汤,随访术后下地时间、骨折愈合时间、并发症,分别记录治疗后3个月、6个月Harris评分。结果两组患者均获得临床随访,手术切口均为I/甲愈合,无明显伤口感染、内固定失败或切割、下肢深静脉血栓形成等并发症发生。所有患者获得骨性愈合,其中观察组术后下地时间为(10.78±1.45)周,骨性愈合时间为(11.28±1.36)周,均较对照组明显缩短(P=0.017,0.045)。两组患者在经过治疗后Harris评分均有所增加。其中观察组Harris评分在治疗后6个月时为(88.67±8.45)分,12个月时为(93.78±6.32)分,均明显高于对照组,显示桃红四物汤有助于患者后期关节功能的恢复和改善(P=0.021,0.033)。结论相比于常规治疗,桃红四物汤配合PFNA治疗可以增加老年骨质疏松性股骨粗隆间骨折的临床疗效,且安全性良好,值得临床推广应用。

ion：Objective To detect the clinical effect and safety of Taohong Siwu decoction combined with PFNA in the treatment of el-derly intertrochanteric fracture. Methods We retrospectively analyzed 45 cases of patients between Jan. 2013 and Jan. 2014, and they were randomly divided into observation group of 23 patients and control group of 22 patients. The control group got regular therapy, while the observation group got Taohong Siwu decoction on the basis of the control group. The postoperative weight-bearing time, clinical healing time of fracture, the Harris score and complications were recorded. Results All patients got followed-up and bone union. There were on wound infection, internal fixation failure and cutting phenomenon or deep vein thrombosis. In the observation group, the postoperative weight-bearing time was 10.78±1.45 weeks, and clinical healing time was 11.28±1.36 weeks, which were shorter than those of the control group. Comparing with the control group, the Harris score of the observation group were higher（88.67 ±8.45 in 6 months postoperatively,93.78±6.32 in 12 months postoperatively）.（ P=0.021, 0.033）. Conclusion Comparing with regular manipulation, Taohong Siwu decoction combined with PFNA can improve therapeutic effect. It is safe, and worthy of clinical promotion.