地奥司明联合氨甲环酸对老年股骨转子间骨折PFNA术后隐性失血和肢体肿胀的影响

Effect of diosmin combined with tranexamic acid on hidden blood loss and limb swelling in elderly patients with intertrochanteric fracture after PFNA

目的探讨地奥司明联合氨甲环酸对老年股骨转子间骨折防旋股骨近端髓内钉(PFNA)术后隐性失血和肢体肿胀的影响。方法研究选取2018年12月~2020年10月收治的102例老年股骨转子间骨折患者作为研究对象,据随机数表法将102例患者分为对照组(n=51)和研究组(n=51),所有患者均给予PFNA手术治疗,对照组术后单纯给予氨甲环酸,研究组在对照组的治疗基础上联合地奥司明进行治疗,比较两组患者术后失血情况以及不同时间段的下肢周径差值、消肿时间及并发症发生率。结果研究组术后隐性失血量、显性失血量、总失血量、输血量均低于对照组,差异对比有统计学意义(P<0.05),研究组术后下肢周径较术前变化差值明显大于对照组,且研究组术后消肿时间短于对照组,差异对比有统计学意义(P<0.05),对照组并发症发生率为19.61%,研究组为3.92%,研究组明显更低,组间差异对比有统计学意义(P<0.05)。结论采用地奥司明联合氨甲环酸可有效降低老年股骨转子间骨折PFNA术后隐性失血量、显性失血量、总失血量和输血量,同时有助于缓解肢体肿胀的现象,降低下肢静脉血栓的发生率。

Objective To investigate the effect of diosmin combined with tranexamic acid on the hidden blood loss and limb swelling after PFNA in elderly patients with intertrochanteric fractures.Methods The study selected 102 elderly patients with intertrochanteric fractures admitted to our hospital from December 2018 to October 2020 as the research objects.According to the random number table method,the 102 patients were divided into a control group(n=51)and a study group(n=51),all patients were treated with PFNA surgery,the control group was given only tranexamic acid after the operation,and the study group was treated with diosmin based on the treatment basis of the control group.The postoperative blood loss,lower limb circumference difference,detumescence time and complication rate of the two groups were compared.Results The hidden blood loss,dominant blood loss,total blood loss and blood transfusion of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).The change difference of lower limb circumference of the study group was significantly greater than that of the control group,and the postoperative detumescence time of the study group was shorter than that of the control group,and the difference was statistically significant(P<0.05).The complication rate of the control group was 19.61%,the study group was 3.92%,shorter than that of the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion The use of diosmin combined with tranexamic acid can effectively reduce the amount of hidden blood loss,dominant blood loss,total blood loss and blood transfusion after PFNA in elderly patients with intertrochanteric fractures,and help relieve limb swelling and reduce the occurrence of venous thrombosis in lower limbs rate.