桃红四物汤配合手术治疗老年股骨颈骨折的临床观察

Clinical observation on Taohong Siwu Decoction with surgery in the treatment of fracture of neck of femur in the elderly

目的探讨桃红四物汤配合手术治疗老年股骨颈骨折患者的临床效果。方法选择我院于2018年9月至2020年9月行全髋关节置换术的老年股骨颈骨折患者82例,采用随机数字表法分为观察组与对照组,每组各41例。两组患者入院均行影像学及血常规等常规检查,均行硬膜外麻醉,由我科经验丰富的医生行全髋关节置换术。对照组于术后给予常规治疗,观察组在对照组基础上服用桃红四物汤。两组疗程均为14 d。比较两组术后下床活动时间和术后住院时间、术前和术后14 d凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体和纤维蛋白原(FIB)]、Harris髋关节功能评分及深静脉血栓形成(DVT)发生情况。结果观察组术后下床活动时间和术后住院时间短于对照组(P<0.05)。术后14 d,观察组PT、APTT长于对照组,而D-二聚体和FIB水平低于对照组(P<0.05)。术后14 d,观察组Harris髋关节功能评分高于对照组(P<0.05)。观察组DVT发生率(21.95%)低于对照组(46.34%)(P<0.05)。结论桃红四物汤配合手术治疗老年股骨颈骨折患者可降低患者血液高凝状态,降低DVT发生,且可改善患者髋关节功能,加快患者术后早期活动及缩短住院时间。

Objective To investigate the clinical efficacy of Taohong Siwu Decoction with surgery in the treatment of fracture of neck of femur in the elderly.Methods A total of 82 elderly patients with fracture of neck of femur who underwent total hip arthroplasty in our hospital from September 2018 to September 2020 were selected.They were divided into the observation group and the control group by using the random number table method,with 41 patients in each group.Upon admission,all the patients in both groups received routine examinations such as imaging examination and blood routine examination.At the same time,they were given epidural anesthesia,and total hip arthroplasty was performed by experienced surgeons in our department.The control group was given conventional treatment after surgery,while the observation group was given oral Taohong Siwu Decoction on the basis of the control group.The course of treatment for both groups was 14 days.The time to get out of bed after surgery,postoperative hospital stay,the coagulation indices before and 14 days after surgery(prothrombin time[PT],activated partial thromboplastin time[APTT],D-dimer and fibrinogen[FIB]),Harris hip function score,and the occurrence of deep vein thrombosis(DVT)were compared between the two groups.Results The time to get out of bed after surgery and postoperative hospital stay in the observation group were shorter than those in the control group(P<0.05).At 14 days after surgery,PT and APTT in the observation group were longer than those in the control group,while D-dimer and FIB levels were lower than those in the control group(P<0.05).At 14 days after surgery,the Harris hip function score in the observation group was higher than that in the control group(P<0.05).The incidence of DVT in the observation group(21.95%)was lower than that in the control group(46.34%)(P<0.05).Conclusion Taohong Siwu Decoction with surgery for elderly patients with fracture of neck of femur can reduce patients'blood hypercoagul ability,decrease the incidence of DVT,and improve patients'hip function,accelerate patients'early postoperative activities and shorten the length of hospital stay.