三七总皂苷对老年骨折术后凝血与骨代谢指标的影响

Effects of Panax Notoginseng Saponins on Indexes of Blood Coagulation and Bone Metabolism in Senile Fracture Patients After Surgery

目的:探讨三七总皂苷(PNS)对老年骨折术后凝血与骨代谢指标的影响。方法:选取2016年1月至2017年6月广东省人民医院南海医院收治的老年股骨粗隆间骨折患者84例作为研究对象,按照随机数字表法分为对照组和观察组,每组42例。2组患者均采用相同的手术疗法,术后对照组给予低分子肝素,观察组给予PNS,比较2组患者治疗后的凝血功能、骨代谢、疼痛、肿胀及疗效。结果:术后14d,2组患者的APTT和PT均较术前升高,而FIB和DDI均较术前下降,差异有统计学意义(P<0.05),但2组患者组间差异无统计学意义(P>0.05);观察组患者的骨密度、T-PINP水平、β-Crosslaps和N-MID水平均高于对照组,差异均有统计学意义(P<0.05);观察组疼痛和肿胀指标均优于对照组,组间比较差异有统计学意义(P<0.05);观察组有效率为57.14%,优于对照组有效率(23.81%)。结论:PNS用于老年骨折术后治疗,具有与肝素相同的抗凝血效果,且能提高骨密度,促进骨折处血肿的吸收,减轻患者疼痛,有利于骨折术后患者的康复。

Objective: To explore the effects of panax notoginseng saponins(PNS)on indexes of blood coagulation and bone metabolism in senile fracture patients after surgery. Methods: A total of 84 senile patients with femoral intertrochanteric fracture admitted in the Nanhai Hospital of Guangdong Provincial People′s Hospital from January 2016 to June 2017 were selected as research objects,and they were randomly divided into control group and observation group,with 42 cases in each group.Both groups received the same surgical treatment.After the surgery,the control group was given low molecular heparin and the observation group was given PNS.The coagulation function,bone metabolism,pain,swelling and efficacy were compared between the 2 groups after the treatment. Results: A total of 14 days after the surgery,the levels of APTT and PT in the 2 groups were higher than those before the surgery,while the levels of FIB and DDI were lower than those before the surgery,with significant difference( P <0.05).However,there was no statistical difference between the 2 groups( P >0.05).The bone mineral density,the level of T-PINP,β-Crosslaps and N-MID in the observation group were all higher than those in the control group,with statistically significant difference( P <0.05).The indexes of pain and swelling in the observation group were better than those in the control group,with statistically significant difference between the 2 groups( P <0.05).The total effective rate in the observation group(57.14%)was significantly higher than that in the control group(23.81%). Conclusion: PNS has the same anticoagulant effect as heparin in the treatment of senile fracture after surgery.It improves bone mineral density,promotes the absorption of hematoma at the fracture area and relieves the pain,which is conducive to the rehabilitation in senile fracture patients.