强筋补骨汤联合C臂辅助下PFNA术式对股骨粗隆间骨折PLT、D-D、IL-13水平的影响

Effect of QiangJinBuGu Decoction combined with PFNA assisted by C-arm on PLT,D-D and IL-13 Levels in Patients with Intertrochanteric Fracture of Femur

目的:研究强筋补骨汤联合C臂辅助下股骨近端防旋髓内钉内固定(PFNA)术式对股骨粗隆间骨折患者血小板计数(PLT)、D-二聚体(D-D)、白细胞介素-13(IL-13)水平的影响。方法:选取2016年3月-2018年3月在我院接受治疗的股骨粗隆间骨折患者120例。通过随机抽签法将其均分成研究组与对照组。对照组予以C臂辅助下PFNA术式治疗,研究组则在对照组的基础上加用强筋补骨汤治疗。分别对比两组在术后恢复情况,术后不同时间段两组髋关节与膝关节功能恢复情况,手术前后两组PLT、D-D、IL-13水平,以及术后并发症等方面的差异。结果:研究组的下床活动时间[(3.84±0.56)d]、骨折愈合时间[(113.88±14.89)d]、完全负重下地时间[(130.22±17.39)d]比对照组[(6.02±0.87)d]、[(150.82±19.85)d]、[(194.73±21.75)d]低(均P<0.05)。研究组术后3、6、12个月的髋关节评分[(64.27±8.14)分]、[(71.60±9.22)分]、[(78.13±9.27)分]、膝关节评分[(88.41±11.48)分]、[(94.17±13.06)分]、[(98.27±14.32)分]比对照组[(52.09±6.23)分]、[(58.54±6.39)分]、[(64.01±7.26)分]、[(79.05±9.33)分]、[(84.07±9.33)分]、[(90.25±13.95)分]高(均P<0.05)。研究组术后7天时的PLT[(225.18±14.28)×10~9/L]、D-D[(92.35±35.28)μg/mL]、IL-13水平[(13.58±2.03)pg/mL]比对照组[(234.75±15.06)×10~9/L]、[(109.66±36.83)μg/mL]、[(19.24±3.48)pg/mL]低(均P<0.05)。研究组与对照组在感染、压疮、深静脉血栓形成、骨折不愈合发生率方面无明显差异(均P>0.05)。结论:强筋补骨汤联合C臂辅助下PFNA术式治疗股骨粗隆间骨折的效果显著,有利于促进患者膝关节以及髋关节功能恢复,改善PLT、D-D、IL-13水平,值得临床推广应用。

Objective To investigate the effect of Qiangjin bugu decoction combined with C-arm assisted proximal femoral anti-rotation intramedullary nail internal fixation(PFNA)on the levels of platelet count(PLT),D-Dimer(D-D)and interleukin-13(IL-13)in patients with intertrochanteric fractures.Methods 120 cases of femoral intertrochanteric fractures treated in our hospital from March 2016 to March 2018 were recorded as observation objects.They were divided into study group and control group by random drawing.The control group was treated with PFNA surgery assisted by C-arm,while the study group was treated with Qiangjin bugu decoction on the basis of the control group.The postoperative recovery of the two groups,the recovery of hip joint and knee joint in different time periods,the PLT,D-D and IL-13 levels before and after surgery and the postoperative complications were compared respectively.Results The study group of the time of movement in bed[(3.84±0.56)d],fracture healing time[(113.88±14.89)d]and time under full load[(130.22±17.39)d]were lower than the control group of[(6.02±0.87)d],[(150.82±19.85)d],[(194.73±21.75)d](P<0.05).The scores of hip joints at 3rd,6th and 12th months after surgery were[(64.27±8.14)],[(71.60±9.22)]and[(78.13±9.27)],and the scores of knee joints were[(88.41±11.48)],[(94.17±13.06)]and[(98.27±14.32)]in the study group,which were higher than those in the control group of[(52.09±6.23)],[(58.54±6.39)],[(64.01±7.26)],[(79.05±9.33)],[(84.07±9.33)]and[(90.25±13.95)](P<0.05).The PLT[(225.18±14.28)×109/L],D-D[(92.35±35.28)μg/ml]and IL-13 levels[(13.58±2.03)pg/ml]at the 7th day after surgery were lower in the study group than those in the control group of[(234.75±15.06)×109/L],[(109.66±36.83)μg/ml]and[(19.24±3.48)pg/ml](P<0.05).The incidence of infection,pressure ulcers,deep vein thrombosis and fracture nonunion observed between the study group and the control group were no significant differences(P>0.05).Conclusion The effect of Qiangjin bugu decoction combined with PFNA assisted by C-arm in the treatment of femoral intertrochanteric fracture is significant,which is conducive to promoting the recovery of knee joint and hip joint function,and improving the levels of PLT,D-D and IL-13.It is worthy of clinical application.