归胶补血糖浆改善股骨转子间骨折术后贫血临床研究

Clinical Study on Guijiao Buxue Syrup in Improving Anemia After Operation for Intertrochanteric Fracture

目的:观察归胶补血糖浆改善气血亏虚型老年股骨转子间骨折患者术后贫血的效果。方法:选取诊断为股骨转子间骨折并已行股骨近端防旋髓内钉手术治疗的144例患者,采用随机数字表法分为2组各72例。2组均采用常规治疗方案,治疗组加予归胶补血糖浆口服,2组均治疗14 d。记录并比较2组患者的失血量,术前及术后检测血红蛋白(Hb)、红细胞压积(Hct)、D-二聚体(D-D)等指标。比较2组的临床疗效。结果:治疗14 d后,治疗组临床疗效总有效率高于对照组,差异有统计学意义(P<0.05)。术后第1天、第3天,2组Hb水平均较术前下降,术后第7天、第14天,2组Hb水平均升高。治疗组术后第1天、第3天、第7天的Hb水平均低于术前(P<0.05),术后第14天的Hb水平与术前比较,差异无统计学意义(P>0.05)。对照组术后第3天、第7天、第14天的Hb水平均低于术前(P<0.05)。2组术后第3天的Hb水平均低于术后第1天(P<0.05)。治疗组术后第7天的Hb水平均较术后第3天升高(P<0.05),对照组术后第7天的Hb水平低于术后第1天(P<0.05)。治疗组术后第14天的Hb水平较术后第1天、第3天、第7天升高(P<0.05)。对照组术后第14天的Hb水平低于术前(P<0.05),高于术后第3天(P<0.05)。治疗组术后第14天的Hb水平高于对照组(P<0.05)。术后第3天,治疗组总失血量及隐性失血量均低于对照组,差异有统计学意义(P<0.05);2组术中失血量比较,差异无统计学意义(P>0.05)。术后第1天、第3天,2组Hct水平均较术前下降,术后第7天、第14天,2组Hct水平均升高。治疗组术后第3天、第7天的Hct水平均低于术前(P<0.05),术后第14天的Hct水平与术前比较,差异均无统计学意义(P>0.05)。对照组术后第3天、第7天、第14天的Hct水平均低于术前(P<0.05)。2组术后第3天的Hct水平均低于术后第1天(P<0.05),术后第7天的Hct水平均较术后第3天升高(P<0.05)。治疗组术后第14天的Hct水平较术后第1天、第3天、第7天升高(P<0.05)。对照组术后第14天的Hct水平低于术前(P<0.05),高于术后第3天(P<0.05)。治疗组术后第14天的Hct水平高于对照组(P<0.05)。结论:老年股骨转子间骨折患者术后服用归胶补血糖浆能减少隐性失血,改善贫血及气血亏虚症状,促进康复,且不增加血栓形成风险。

Objective:To observe the effect of Guijiao Buxue Syrup in improving anemia after operation for intertrochanteric fracture of deficiency of qi and blood type in senile patients. Methods: A total of144 cases of patients diagnosed with intertrochanteric fracture and underwent proximal femoral nail antirotation were selected and divided into two groups according to the random number table method,with72 cases in each group. Both groups were treated with routine treatment,and the treatment group was additionally given the oral administration of Guijiao Buxue Syrup. Both groups were treated for 14 days. The blood loss,and the indexes including hemoglobin(Hb),hematocrit(Hct) and D-dimer(D-D) before and after operation in the two groups were recorded and compared. The clinical effect in the two groups were compared. Results:After 14 days of treatment,the total effective rate of clinical effect in the treatment group was higher than that in the control group,the difference being significant(P<0.05). On the first and third days after operation, the Hb levels in the two groups were decreased when compared with those before operation;on the seventh and fourteenth days after operation, the Hb levels in the two groups were increased. On the first,third and seventh days after operation,the Hb levels in the treatment group were lower than those before operation(P<0.05), and there was no significance being found in the Hb levels on the fourteenth day after operation and before operation(P>0.05). On the third, seventh and fourteenth days after operation,the Hb levels in the control group were lower than those before operation(P<0.05). On the third day after operation,the Hb levels in the two groups were lower than those on the first day after operation(P<0.05). The Hb level in the treatment group on the seventh day after operation was increased when compared with that on the third day after operation(P<0.05). The Hb level in the control group on the seventh day after operation was decreased when compared with that on the first day after. On the fourteenth day after operation,the Hb level in the treatment group was higher than that on the first day, third and seventh day after operation(P<0.05). On the fourteenth day after operation, the Hb level in the control group was lower than that before operation(P<0.05) and higher than that on the third day after operation(P<0.05). On the fourteenth day after operation,the Hb level in the treatment group was higher than that in the control group(P<0.05). On the third day after operation, the total blood loss and hidden blood loss in the treatment group were lower than those in the control group,the difference being significant(P<0.05);there was no significant difference being found in the comparison of intraoperative blood loss between the two groups(P>0.05). On the first and third days after operation,the Hct levels in the two groups were decreased when compared with those before operation, and on the seventh and fourteenth days after operation,the Hct levels in the two groups were increased. On the third and seventh days after operation, the Hct levels in the treatment group were lower than those before operation(P<0.05), and there being no significant difference being found in the comparison of the Hct level on the fourteenth day after operation and before operation(P>0.05). On the third, seventh and fourteenth days after operation,the Hct levels in the control group were lower than those before operation(P<0.05). On the third day after operation, the Hct levels in the two groups were lower than those on the first day after operation(P<0.05),and the Hct levels on the seventh day after operation were increased when compared with that on the third day after operation(P<0.05). the Hct level on the fourteenth day after operation in the treatment group was increased when compared with that on the first,third and seventh day after operation(P<0.05). The Hct level on the fourteenth day after operation in the control group was lower than that before operation(P<0.05) and higher than that on the third day after operation(P<0.05). On the fourteenth day after operation, the Hct level in the treatment group was higher than that in the control group(P<0.05).Conclusion: After operation, the senile patients with intertrochanteric fracture who take Guijiao Buxue Syrup can reduce the hidden blood loss,improve the symptoms of anemia and deficiency of qi and blood and promote rehabilitation,without increasing the risk of thrombosis.