[1]李 军,凌家保,李崇德,等.加味十全大补汤对老年股骨粗隆间骨折患者术后隐性失血及血糖水平的影响*[J].陕西中医,2020,(9):1254-1257.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.022]
 LI Jun,LING Jiabao,LI Chongde,et al.Effects of Jiawei Shiquan Dabu decoction on recessive blood loss and blood glucose levels after operation in the elderly patients with femoral intertrochanteric fracture[J].,2020,(9):1254-1257.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.022]
点击复制

加味十全大补汤对老年股骨粗隆间骨折患者术后隐性失血及血糖水平的影响*
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年9期
页码:
1254-1257
栏目:
临床研究
出版日期:
2020-09-05

文章信息/Info

Title:
Effects of Jiawei Shiquan Dabu decoction on recessive blood loss and blood glucose levels after operation in the elderly patients with femoral intertrochanteric fracture
作者:
李 军凌家保李崇德黄光平
四川省简阳市人民医院中医骨科(简阳 641400)
Author(s):
LI JunLING JiabaoLI Chongdeet al.
Department of Orthopaedics of Traditional Chinese Medicine,Jianyang People's Hospital in Sichuan Province(Jianyang 641400)
关键词:
股骨粗隆间骨折 防旋型股骨近端髓内钉 加味十全大补汤 老年人 血红蛋白 红细胞比容 隐性失血
Keywords:
Femoral intertrochanteric fracture Proximal femoralnail antirotation Jiawei Shiquan Dabu decoction Elderly Hemoglobin Hematocrit Recessive blood loss
分类号:
R274.1
DOI:
DOI:10.3969/j.issn.1000-7369.2020.09.022
文献标志码:
A
摘要:
目的:探讨加味十全大补汤对老年股骨粗隆间骨折患者术后隐性失血及血糖水平的影响。方法:选取120例老年股骨粗隆间骨折患者,随机分为两组,各60例。两组均行防旋型股骨近端髓内钉(PFNA),对照组术前不予以药物治疗,观察组术前3 d予以加味十全大补汤。统计两组住院时间、骨折愈合时间,对比术前、术后1 d、3 d、7 d血红蛋白(Hb)、红细胞比容(Hct)水平、隐性失血量、空腹血糖水平,并于术后6个月随访,观察髋关节恢复情况。结果:术后1 d、3 d、7 d,观察组Hb、Hct水平高于对照组(P<0.05)。观察组术后1~3 d、3~7 d隐性失血量分别为(245.74±88.26)ml、(188.26±70.12)ml,均少于对照组(288.67±90.94)ml、(245.94±75.36)ml(P<0.05)。术后1 d、3 d、7 d,观察组空腹血糖水平分别为(7.74±0.76)mmol/L、(6.26±0.52)mmol/L、(5.12±0.46)mmol/L均低于对照组(9.67±0.84)mmol/L、(7.94±0.66)mmol/L、(6.48±0.52)mmol/L(P<0.05)。观察组骨折愈合时间、住院时间短于对照组(P<0.05)。术后6个月随访,观察组髋关节功能恢复优良率91.38%与对照组84.21%,组间比较差异无统计学意义(P>0.05)。结论:加味十全大补汤治疗老年股骨粗隆间骨折患者,可纠正贫血,减少隐性失血量,加快骨折愈合,缩短住院时间,且对血糖水平影响较小。
Abstract:
Objective:To investigate the effect of Jiawei Shiquan Dabu decoction on postoperative recessive blood loss and blood glucose levels in elderly patients with femoral intertrochanteric fracture.Methods:120 elderly patients with femoral intertrochanteric fracture were selected,simple randomization grouped,60 cases in each.Both groups received proximal femoralnail antirotation(PFNA),the control group was not treated with drugs before operation,the observation group received Jiawei Shiquan Dabu decoction for treatment 3 d before surgery.The hospitalization time and fracture healing time were compared between the two groups,the hemoglobin(Hb),hematocrit(Hct)level,recessive blood loss and fasting blood glucose level were compared before and 1 d,3 d,7 d after operation,the patients were followed up for 6 months to observe the hip joint recovery.Results: At 1 d,3 d,and 7 d after surgery,the levels of Hb and Hct in the observation group were higher than those in the control group(P<0.05).The recessive blood loss of(245.74±88.26)ml,(188.26±70.12)ml in the observation group 1~3 d and 3~7 d after the operation was less than that in the control group(288.67±90.94)ml,(245.94±75.36)ml(P<0.05).1 d,3 d,and 7 d after surgery,the fasting blood glucose levels of(7.74±0.76)mmol/L,(6.26±0.52)mmol/L,and(5.12±0.46)mmol/L in the observation group were lower than those in the control group(9.67±0.84)mmol/L,(7.94±0.66)mmol/L,(6.48±0.52)mmol/L(P<0.05).The fracture healing time and hospital stay in the observation group were shorter than those in the control group(P<0.05).After 6 months of follow-up,the excellent recovery rate of hip joint function in the observation group was 91.38%,compared with 84.21% in the control group.There was no significant difference(P>0.05).Conclusion:Jiawei Shiquan Dabu decoction is applied to elderly patients with femoral intertrochanteric fracture,which can correct anemia and reduce recessive blood loss,accelerate fracture healing,shorten hospital stay,and have less effect on blood glucose levels.

参考文献/References:

[1] 王 炜,李富航,闫相斌,等.人工关节置换与内固定治疗骨质疏松性不稳定股骨粗隆间骨折对比分析[J].陕西医学杂志,2017,46(1):88-89.
[2] Wang B,Liu Q,Liu Y,et al.Comparison of proximal femoral nail antirotation and dynamic hip screw internal fixation on serum markers in elderly patients with intertrochanteric fractures[J].J Coll Physicians Surg Pak,2019,29(7):644-648.
[3] 王一新,吴相桥,杜辉君,等.两种手术方式治疗老年人不稳定型股骨粗隆间骨折失血量的比较[J].中华老年医学杂志,2018,37(1):71-73.
[4] 张 然,许 勤.外科非糖尿病患者应激性高血糖的研究进展[J].护理学报,2017,24(4):34-38.
[5] 王亦璁.骨与关节损伤[M].北京:人民卫生出版社,2007:180.
[6] 国家中医药管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:356-360.
[7] 袁 斌,葛保健,孟柏屹,等.股骨近端防旋转髓内钉与股骨近端锁定加压板治疗股骨转子下骨折的比较[J].骨科,2017,8(6):459-463,472.
[8] Talmac MA,Gorgel MA,Armaan R,et al.Examining implant superiority in the treatment of simple pertrochanteric fractures of the proximal femur in elderly patients[J].Ulus Travma Acil Cerrahi Derg,2019,25(4):410-416.
[9] 王 鑫,闫 斌.中西医结合治疗对老年股骨粗隆间骨折术后髋关节功能的影响[J].陕西中医,2017,38(7):928-929.
[10] 栾斐宇,王文波.高龄股骨粗隆间骨折手术治疗进展[J].医学综述,2017,23(17):3441-3444,3449.
[11] Jung EY,Oh IT,Shim SY,et al.The effect of valgus reduction on the position of the blade of the proximal femoral nail antirotation in intertrochanteric hip fractures[J].Clin Orthop Surg,2019,11(1):36-42.
[12] 雷金来,张斌飞,庄 岩,等.氨甲环酸减少股骨粗隆间骨折PFNA内固定手术隐性失血的随机对照试验[J].中国骨与关节损伤杂志,2018,33(12):1244-1246.
[13] 朱 芸,张 博,贺小兵,等.红细胞生成素联合铁剂治疗股骨粗隆间骨折围手术期贫血的疗效分析[J].局解手术学杂志,2017,26(10):727-731.
[14] 洪小丽,蔡义红.PFNA治疗老年股骨粗隆间骨折隐性失血的观察与护理[J].创伤外科杂志,2017,19(9):708-709.
[15] 陈 妍,杨新春.髋骨骨折后应激性高血糖症与非糖尿病患者急性心肌梗死风险增加的关系[J].中华内科杂志,2013,52(10):862.
[16] 尚芬兰,徐晶晶,赫荣波,等.骨转换标志物在糖尿病中的研究进展[J].中国骨质疏松杂志,2017,23(4):541-547.
[17] 郑应麟,杨治芳.降糖药物对骨代谢及骨折风险的影响[J].中国骨质疏松杂志,2019,25(1):118-122.
[18] 段 彪,李希文,刘 军,等.中药辅助治疗老年髋部骨折的用药规律研究[J].中医药导报,2017,23(13):51-54.

备注/Memo

备注/Memo:
*四川省卫生和计划生育委员会资助项目(17PJ212)
更新日期/Last Update: 2020-09-08