摘要
目的通过血栓弹力图(TEG)观察早期应用活血利水法治疗对髋部骨折术后凝血状态的影响。方法选取股骨颈骨折或股骨粗隆间骨折患者60例,按照随机数字表法分为治疗组和对照组,各30例。所有股骨颈骨折患者行人工髋关节置换术,股骨粗隆间骨折患者行股骨近端髓内钉(PFNA)内固定术,术后给予常规治疗。治疗组在此基础上,术后次日起口服活血利水类中药汤剂,7 d为1个疗程。分别于术后第1、第7日测定患者大腿围及TEG指标。结果术后第1日,2组大腿围、TEG指标及凝血状态比较,差异无统计学意义(P>0.05);术后第7日,治疗组CI值、MA值、α角低于对照组,K时间高于对照组,大腿围小于对照组,血液高凝患者人数少于对照组,差异均有统计学意义(P<0.05)。结论在髋部骨折术后早期应用活血利水法治疗能够有效减轻术后肿胀,改善患者TEG指标,减少血液高凝状态的发生,加速术后康复。
Objective To observe the clinical effect of the method for promoting blood circulation and diuresis in early stage after hip fracture operation based on thrombelastogram(TEG).Methods 60 patients with femoral neck fracture or intertrochanteric fracture were randomly divided into treatment group and control group with 30 cases each.The patients with intertrochanteric fracture were treated with Proximal Femoral Nail Antirotation(PFNA),those with femoral neck fracture were treated with artificial hip replacement.All patients were given routine treatment after operation.The treatment group was given Taohong Siwu Decoction and Wuling Powder on the next day after surgery for 1 weeks in addition to routine treatment.On the 1st and 7th day after surgery,fracture clinical syndrome score(FCSS)and TEG were determined.Results On the 1st day after operation,there was no significant difference in thigh circumference,TEG index and coagulation state between the two groups(P>0.05).On the 7th day after operation,CI,MA,α in the treatment group were lower than those in the control group,K time was longer than that of the control group,the thigh circumference of the treatment group was smaller than that of the control group,the number of hypercoagulable patients was less than that of the control group.The difference was statistically significant(P<0.05).Conclusion Early application of Taohong Siwu Decoction after hip fracture operation can effectively reduce postoperative swelling,improve the TEG Index and reduce the occurrence of hypercoagulable state so as to accelerate the early recovery of patients after operation.
作者
宋洁菲
周迎光
胡妍
陈建斌
SONG Jie-fei;ZHOU Ying-guang;HU Yan;CHEN Jian-bin(The First Medical College,Nanjing University of Chinese Medicine,Nanjing 210023,China;Orthopedics Department,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004;Department of Clinical Laboratory,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004)
出处
《北京中医药》
2024年第1期44-47,共4页
Beijing Journal of Traditional Chinese Medicine
基金
南京医科大学康达学院科研发展基金(KD2021KYYB2155)
连云港市卫生科技项目(202017)。
关键词
活血利水法
桃红四物汤
五苓散
股骨粗隆间骨折
股骨颈骨折
血栓弹力图
Method for promoting blood circulation and diuresis
Taohong Siwu Decoction
Wuling Powder
intertrochanteric fracture
femoral neck fracture
thromboelastogram
