地奥司明联合氨甲环酸治疗老年股骨转子间骨折术后隐性失血的疗效分析  

Analysis of therapeutic effect of diosmin plus tranexamic acid for hidden blood loss in elderly patients with intertrochanteric fracture after surgery

作　　者：王晓冬[1] 姜媛媛[2] 王建忠[1] 高文山[1] 

机构地区：[1]河北大学附属医院骨科,河北保定071000 [2]河北大学附属医院手术室,河北保定071000

出　　处：《实用临床医药杂志》2013年第21期139-142,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11321138)

摘　　要：目的探讨地奥司明联合氨甲环酸治疗老年股骨转子间骨折术后隐性失血及肢体肿胀的疗效。方法将采用近端防旋髓内钉(PFNA)的75例老年股骨转子间骨折患者随机分为2组,治疗组38例入院后即给予地奥司明,手术开始时给予氨甲环酸,静脉滴注,对照组37例术中按照相同方法给予氨甲环酸。分别计算2组可见失血量、总失血量及隐性失血量,并比较患肢膝关节上方10 cm肢体周径差值。结果治疗组隐性失血量及总失血量均明显少于对照组,差异有统计学意义;术后3、5、7 d时,治疗组肢体周径缩小值及肿胀减轻程度上明显优于对照组,差异有统计学意义;治疗组未发现静脉血栓形成,对照组4例出现肌间静脉血栓形成,2组均未出现下肢深静脉血栓、肺栓塞等严重并发症。结论地奥司明联合氨甲环酸能有效减少转子间骨折PFNA术后隐性失血及肢体肿胀,疗效优于单纯氨甲环酸,值得临床推广。Objective To investigate the therapeutic effects of diosmin plus tranexamic acid for hidden blood loss and limb swelling in elderly patients with intertrochanteric fracture after surgery. Methods Seventy- five elderly patients with intertrochanteric fracture treated by proxi- mal femoral nail antirotation （PFNA） were randomly divided into two groups. The treatment group （n= 38） was give diosmin immediately after admission into hospital and tranexamic acid by intra- venous dripping at the beginning of surgery, while the control group （n = 37） given tranexamic acid according to the same method during surgery. The amount of visible, hidden and total blood loss was calculated, respectively, and the difference of limb circumference away from 10 cm above the affected knee joint was compared. Results The amount of hidden and total blood loss in treatment group was evidently less than in the control group, with significant difference. Lessened values of limb circumference and reduced swelling degrees in the treatment group were all markedly superior to the control group on day 3, 5 and 7 after surgery, and the differences had statistical significance. There was no one with phlebothrombosis in the treatment group, while 4 cases in the control group. Besides, no one suffered from severe complications like deep venous thrombosis and pulmonary em- bolism in two groups. Conclusion Diosmin combined with tranexamine acid can effectively reduce the hidden blood loss and limb swelling of intertrochanteric fracture treated by PFNA after surgery, with therapeutic effect superior to tranexamine acid, so it deserves to be popularized in clinic.

关 键 词：股骨转子间骨折 隐性失血 地奥司明 氨甲环酸 

分 类 号：R683.4[医药卫生—骨科学]