当归补血汤治疗老年粗隆间骨折抗旋转股骨近端髓内钉术后隐性失血的临床效果

Clinical effect of Angelicae Sinensis Decoction for Supplementing Blood in the treatment of recessive hemorrhage of senile intertrochanteric fracture of femur after proximal femoral nail anti-rotation

目的探讨当归补血汤治疗老年粗隆间骨折抗旋转股骨近端髓内钉(PFNA)术后隐性失血患者的临床效果。方法选取我院2014年5月~2016年11月收治的60例实施PFNA治疗的老年股骨粗隆间骨折患者作为研究对象,随机分为研究组与对照组,每组30例。研究组给予当归补血汤治疗,对照组给予硫酸亚铁片治疗。观察对比两组的血红蛋白(Hb)、血细胞比容(Hct)、髋关节功能评分(Harris评分)、并发症发生率。结果两组术前1 d的Hb、Hct水平比较,差异无统计学意义(P>0.05);研究组术后5、7 d的Hb、Hct水平均高于对照组,差异有统计学意义(P<0.05)。研究组术后30 d、术后3个月的Harris评分显著高于对照组,差异有统计学意义(P<0.05)。两组术后半年的Harris评分比较,差异无统计学意义(P>0.05)。研究组的总并发症发生率为10.0%,显著低于对照组的36.6%,差异有统计学意义(P<0.05)。结论当归补血汤在PFNA治疗老年股骨粗隆间骨折隐性失血中的临床效果显著,可改善患者术后骨折隐性失血状况,加快髋关节功能的恢复,且并发症少,安全性高,值得临床推广应用。

Objective To explore the clinical effect of Angelicae Sinensis Decoction for Supplementing Blood in the treatment of recessive hemorrhage of senile intertrochanteric fracture of femur after proximal femoral nail anti-rotation （PFNA）.Methods Altogether 60 elderly patients with intertrochanteric fracture of femur who were treated with PFNA from May 2014 to November 2016 in our hospital were selected and randomly divided into the study group and the control group,with 30 cases in each group.The study group was treated with Angelicae Sinensis Decoction for Supple- menting Blood,while,the control group was treated with Ferrous Sulfate Tablets.The hemoglobin （Hb）,hematocrit （Hct）, hip joint function score （Harris score） and the incidence rate of complications of the two groups were observed and compared.Results The level of Hb and Hct of the two groups at pre-operative 1 day were not statistically significant （P〉0.05）.The level of Hb and Hct of the study group at post-operative 5 and 7 days were significantly higher than those of the control group,with statistically significant difference （P〈0.05）.The Harris score of the study group at post-opera- tive 30 days and 3 months was significantly higher than that of the control group,with statistically significant difference （P〈0.05）.There was no significant difference in the Harris score of the two groups after half a year （P〉0.05）.The total inci- dence rate of complications of the study group was 10.0%,which was significantly lower than that of the control group （36.6%）,with statistically significant difference （P〈0.05）.Conclusion Angelieae Sinensis Decoction for Supplementing Blood has significant clinical effect in the treatment of senile intertrochanterie fracture of femur with recessive hemorrhage af- ter PFNA,and can improve post-operative hidden blood loss,accelerate the recovery of hip joint functions with fewer complications and higher safety,which is worthy of clinical application and promotion.