活血续骨汤配合快速康复外科理念在老年股骨粗隆间骨折术后患者中的应用效果

Clinical Study on Effect of Huoxue Xugu Tang Combined with Theory of Fast Track Surgery for Senile Patients after Femoral Intertrochanteric Fracture Surgery

目的:观察活血续骨汤配合快速康复外科理念对老年股骨粗隆间骨折患者术后关节功能、骨代谢指标及并发症的影响。方法:将160例老年股骨粗隆间骨折患者随机分为治疗组和对照组各80例,2组均采用股骨近端防旋髓内钉进行手术。治疗组给予活血续骨汤配合快速康复外科理念干预,对照组采用常规护理措施干预。治疗后比较2组临床疗效、关节功能、骨代谢相关指标、足背动脉情况及术后并发症发生情况。结果:治愈率治疗组51.25%,对照组33.75%,2组比较,差异有统计学意义(P<0.01)。术后,2组髋关节功能评分均较治疗前升高,差异均有统计学意义(P <0.01);治疗组髋关节功能评分均高于同期对照组,差异均有统计学意义(P <0.01)。治疗后,2组骨碱性磷酸酶(BALP)、骨钙素(BGP)、I型前胶原羧基端肽(PICP)水平均较治疗前上升,I型胶原羧基端肽β特殊序列(β-CTX)、总骨I型前胶原氨基端延长肽(t-PINP)水平均较治疗前下降,差异均有统计学意义(P <0.01);治疗组BALP、BGP、PICP水平均高于对照组,t-PINP、β-CTX水平均低于对照组,差异均有统计学意义(P <0.01)。治疗后,2组足背动脉管径、血流量、血流峰时度均较治疗前增大,差异均有统计学意义(P <0.01);治疗组足背动脉管径、血流量、血流峰时度均大于对照组,差异均有统计学意义(P <0.01)。术后并发症发生率治疗组7.50%,对照组25.00%,2组比较,差异有统计学意义(P <0.01)。结论:活血续骨汤配合快速康复外科理念干预老年股骨粗隆间骨折术后患者,能提高治愈率,改善患者的髋关节功能及骨代谢相关指标,减少术后并发症。

Objective:To observe the effect of Huoxue Xugu tang combined with the theory of fast track surgery on the joint function,the bone metabolic markers and the complications of senile patients after femoral intertrochanteric fracture surgery.Methods:A total of 160 cases of senile patients with femoral intertrochanteric fracture were randomly divided into the treatment group and the control group,80 cases in each group.Both groups recieved surgery of proximal femoral nail anti-rotation.The treatment group was additionally treated with Huoxue Xugu tang combined with the theory of fast track surgery,and the control group was additionally given the intervention of routine nursing measures.The clinical effect,the joint function,the related indexes of bone metabolism,the situations of dorsalis pedis artery and the occurrence of postoperative complications in the two groups after treatment were compared.Results:The cure rate was 51.25%in the treatment group and 33.75%in the control group,the difference being significant(P<0.01).After surgery,the scores of hip joint function in the two groups were increased when compared with those before treatment,differences being significant(P<0.01);the score of hip joint function in the treatment group was higher than that in the control group at the same period,differences being significant(P<0.01).After treatment,the levels of bone alkaline phosphatase(BALP),bone Gla protein(BGP)and procollagen type 1 C-terminalpropeptide(PICP)in the two groups were increased when compared with those before treatment,while the levels of procollagen type 1 C-terminal propeptideβ-specific sequence(β-CTX)and total procollagen type 1 N-terminal propeptide(t-PINP)in the two groups were decreased when compared with those before treatment,differences being significant(P<0.01);the levels of BALP,BGP and PICP in the treatment group were higher than those in the control group,while the levels of t-PINP andβ-CTX in the treatment group were lower than those in the control group,differences being significant(P<0.01).After treatment,the diameter,the blood flow and the peak of blood flow of dorsalis pedis artery in the two groups were increased when compared with those before treatment,differences being significant(P<0.01);the diameter,the blood flow and the peak of blood flow of dorsalis pedis artery in the treatment group were higher than those in the control group,differences being significant(P<0.01).The incidence of postoperative complications was 7.50%in the treatment group and 25.00%in the control group,the difference being significant(P<0.01).Conclusion:The intervention of Huoxue Xugu tang combined with the theory of fast track surgery for senile patients after femoral intertrochanteric fracture surgery can improve the cure rate,the hip joint function as well as the related indexes of bone metabolism of patients and reduce the incidence of postoperative complications.