中药辅助髋关节置换术治疗老年股骨颈骨折的临床疗效

Clinical Efficacy of Chinese Medicine Adjuvant Hip Replacement in the Treatment of Elderly Femoral Neck Fracture Patients

目的:探究中药辅助髋关节置换术对老年股骨颈骨折患者的临床疗效。方法:选取2015年3月至2017年3月六安市中医院收治的老年股骨颈骨折患者107例作为研究对象,按照随机数字表法分为对照组(n=53)和观察组(n=54)。所有患者均行髋关节置换术治疗,术后对照组患者给予常规治疗,观察组患者在对照组的基础上联合活血化瘀中药治疗。6个月后,统计2组临床疗效,采用Harris评分系统评估并比较2组患者术后髋关节功能评分及优良率;比较2组患者术后随访期间康复情况。结果:术后6个月,观察组临床治疗有效率为92.59%,较对照组的77.36%显著升高,差异有统计学意义(P<0.05);与术前比较,术后6个月2组Harris系统中疼痛、畸形、活动度评分及观察组功能评分升高,差异有统计学意义(P<0.05),且观察组高于对照组,差异有统计学意义(P<0.05);术后3个月对照组及观察组髋关节功能优良率分别为9.43%、24.07%,术后6个月分别为28.30%、48.15%,与术前比较,术后3、6个月2组患者髋关节功能优良率显著升高,差异有统计学意义(P<0.05),且观察组显著高于对照组,差异有统计学意义(P<0.05)。随访结果显示,术后观察组患者骨折愈合时间较对照组显著缩短,差异有统计学意义(P<0.05),股骨头坏死发生率也显著低于对照组,差异有统计学意义(P<0.05),但2组骨折不愈及骨塌陷发生率差异无统计学意义(P>0.05)。讨论:活血化瘀中药辅助髋关节置换术可有效改善老年股骨颈骨折患者髋关节功能,促进骨折愈合,显著提高患者临床疗效并减少股骨头坏死的发生。

Objective: To explore the clinical efficacy of Chinese medicine adjuvant hip replacement in the treatment of elderly femoral neck fracture patients. Methods: A total of 107 cases of elderly femoral neck fracture patients in Traditional Chinese Hospital of Luan were selected and divided randomly into a control group( n =53)and an observation group( n =54).All patients were treated with hip replacement.After operation,the patients in the control group were given routine treatment,while the patients in the observation group were treated with traditional Chinese medicine for promoting blood circulation and removing blood stasis on the basis of the control group.The clinical efficacy of the 2 groups after 6 months was statisticsed,and the hip joint function score and recovery rate of 2 groups were evaluated and compared by Harris score system;The recovery of patients in the 2 groups during postoperative follow-up was compared. Results: The total effective rate of the observation group was 92.59% in 6 months post-operation,which was significantly higher than that 77.36% of the control group significantly( P <0.05);Compared with pre-operation,the scores of pain,malformation,mobility in Harris score system of 2 groups and the function score of the observation group increased significantly( P <0.05 or P <0.01),and the observation group was higher than the control group significantly( P <0.05);The hip joint function recovery rate of the control group and the observation group in 3 months post-operation were 9.43%,24.07%,and 6 months post-operation were 28.30%,48.15%.Compared with pre-operation,the hip joint function recovery rate of 2 groups in 3 and 6 months post-operation increased significantly( P <0.05 or P <0.01),and the observation group was higher than the control group( P <0.05);The result of following-up showed that,the fracture healing time of the observation group shortened significantly compared with the control group( P <0.01),the occurrence rate of femoral head necrosis in observation group was lower than that in control group( P <0.01),while the occurrence rates of nonunion and bone collapses in the 2 groups had no significant difference( P >0.05). Conclusion: Activating blood circulation and removing blood stasis of Chinese medicine adjuvant hip replacement can improve the hip joint function of elderly femoral neck fracture patients,promote the fracture healing,enhance the clinical efficacy and reduce the occurrence of femoral head necrosis.