丹参川芎嗪注射液联合外固定术治疗桡骨远端骨折的临床效果

Clinical Value of Salvia Miltiorrhiza Injection Combined with External Fixation for Distal Radius Fracture

目的:探讨于桡骨远端骨折行外固定术后应用丹参川芎嗪中药制剂治疗的临床价值。方法:将2017年11月—2019年12月我院普外科收治的行外固定术治疗的56例桡骨远端骨折患者资料进行回顾性分析,依据术后治疗方式不同,分为研究组(28例)和常规组(28例),观察两组治疗前后患肢肿胀指数、血清D-二聚体、纤维蛋白原(FIB)及治疗后骨折功能恢复情况DASH评分、骨折影像愈合所需时间、腕关节功能Mayo评分及并发症(浅表感染、腕管综合征、慢性疼痛、血栓)发生情况。结果:治疗前,研究组于常规组的患肢肿胀指数、血清D-二聚体与FIB水平分别为(2.15±0.56)分vs(2.09±0.59)分、(20.03±2.48)mg/L vs(19.79±2.50)mg/L、(14.13±3.08)g/L vs(14.39±3.12)g/L,差异无统计学意义(P>0.05)。治疗后,研究组患肢肿胀指数、血清D-二聚体与FIB水平均低于常规组分别为(0.43±0.11)分vs(1.07±0.09)分、(3.74±0.21)mg/L vs(6.43±0.48)mg/L、(2.76±0.54)g/L vs(5.38±0.61)g/L,常规组DASH评分与骨折影像愈合所需时间均高于研究组分别为(45.37±8.56)分vs(36.85±7.72)分、(11.54±2.16)周vs(8.47±1.09)周,差异均有统计学意义;研究组的腕关节功能Mayo评分优良率为89.29%(25/28),高于常规组64.29%(18/28),差异有统计学意义;研究组发生浅表感染、腕管综合征、慢性疼痛及血栓并发症的总例数为3例,显著少于常规组的10例,差异有统计学意义(P<0.05)。结论:临床将丹参川芎嗪中药制剂用于桡骨远端骨折外固定术的患者,不仅具有减轻患肢的肿胀程度、缩短影像愈合时间、利于腕关节功能恢复等优势,还能改善凝血功能,减少各种可能并发症的发生。

Objective To explore the clinical value of salvia miltiorrhiza traditional medicine preparation after external fixation of distal radius fractures.Methods A retrospective comparison and analysis of all clinical data of 56 patients with distal radius fractures treated by general surgery during the period from November 2017 to December 2019 according to different treatment options.They were divided into research group(perform routine treatment+Danshen ligustrazine injection,28 cases)and conventional group(perform routine treatment after operation,28 cases).We observe the swelling index of the affected limb before and after treatment in the two groups,various indicators of serum coagulationD-dimer,fibrinogen(FIB)and the recovery of fracture function after treatment DASH score,time required for fracture image healing,wrist joint function Mayo score and complications(superficial infection,wrist Tube syndrome,chronic pain and thrombosis).Results Before treatment,the swelling index of the affected limb,serum D-dimer and FIB levels were(2.15±0.56)vs(2.09±0.59),(20.03±2.48)vs(19.79±2.50),(14.13±3.08)vs(14.39±3.12),which with no difference between the study group and the conventional group(P>0.05).After treatment,the swelling index,serum D-dimer and FIB levels in the study group were lower than those in the conventional group,which were(0.43±0.11)vs(1.07±0.09),(3.74±0.21)vs(6.43±0.48),(2.76±0.54)vs(5.38±0.61).The DASH score and fracture image healing time of the conventional group were higher than those of the study group(45.37±8.56)vs(36.85±7.72),(11.54±2.16)vs(8.47±1.09).The excellent rate of wrist joint function Mayo score was 89.29%(25/28)in the study group than 64.29%(18/28)in the conventional group.The total number of superficial infection,carpal tunnel syndrome,chronic pain and thrombosis complications occurred in the study group was 3 cases,which was significantly less than 10 cases in the conventional group,and the contrast indicators were different(P<0.05).Conclusion The clinical application of salvia miltiorrhiza ligustrazine in patients with distal radius fracture external fixation has the advantages,which not only reducing the swelling of the affected limb,shortening the image healing time,but also helping to restore the function of the wrist joint.It can also improve the blood coagulation function and reduce the occurrence of various possible complications.