四君子汤合五味消毒饮加减预防老年髋部骨折术后切口感染临床研究

Clinical Study on the Prevention of Postoperative Infection of Incision after Hip Fracturein Elderly Patients by Modified Sijunzi Decoction and Wuwei Xiaodu Decoction

目的观察四君子汤合五味消毒饮加减预防老年髋部骨折术后切口感染的临床疗效。方法选取老年髋部骨折拟择期手术患者50例,按照随机数字表法分为治疗组26例与对照组24例。对照组术前、术后给予五水头孢唑林钠预防性治疗1次,治疗组术后预防性抗生素治疗同对照组,同时术后加服四君子汤合五味消毒饮加减。观察比较两组术后切口感染发生率、第1、3、7、14 天白细胞总数、超敏C反应蛋白、体温等指标,以评估预防术后切口感染疗效。结果术后切口感染率分别为治疗组0%,对照组16.7%,两组感染率比较差异有统计学意义(P<0.01);治疗组白细胞总数、C反应蛋白、体温在术后第1、3、7天均低于对照组(P<0.05),术后第14天两组比较,差异无统计学意义(P>0.05)。结论四君子汤合五味消毒饮加减预防老年髋部骨折术后切口感染疗效显著,值得临床推广。

Objective To observe the clinical effects of Sijunzi Decoction combined with Wuwei Xiaodu Decoctionin preventing postoperative infection of incision after hip fracture in the elderly. Methods A total of 50 elderly patients were selected for elective surgery for hip fractureand were randomly divided into a treatment group and a control group according to random number table.There were 26 cases in the treatment group and 24 cases in the control group. In the control group, preoperative and postoperative preventive treatment with cefazolin sodium was given once, and postoperative prophylactic antibiotics in the treatment group were the same as in the control group. Meanwhile, Sijunzi Decoction and WuweiXiaoduDecoctionwere added after surgery. The incidence of infection, total white blood cells, C-reactive protein, body temperature and other indicators were compared between the 2 groups at day 1, day 3, day 7 and day 14 to evaluate the efficacy of prevention of postoperative incision infection. Results Postoperative infection rate was 0% in the treatment group and 16.7% in the control group, and the difference in infection rate between the 2 groups was statistically significant (P<0.01). The differences of total white blood cell count, C-reactive protein, and body temperature between the 2 groups on day 1, 3 and 7 after operation were statistically significant (P<0.05). Conclusion The effect of Sijunzi Decoction and Wuwei Xiaodu Decoctionon the prevention of postoperative infection of hip fracture in the elderly is remarkable and worthy of clinical promotion.