补阳还五汤加减对股骨粗隆间骨折术后患者凝血功能及隐性失血的影响  

Effects of Modified Buyang Huanwu Decoction on Postoperative Coagulation Function and Hidden Blood Loss in Patients with Femoral Intertrochanteric Fractures

作　　者：夏启水 程毅[1] 李强[1] 邓晖[1] 周雄[1] 支乐[1] XIA Qishui;CHENG Yi;LI Qiang;DENG Hui;ZHOU Xiong;ZHI Le(Nanchang Hongdu Hospital of Traditional Chinese Medicine,Nanchang Jiangxi 330006,China)

机构地区：[1]南昌市洪都中医院,江西南昌330006

出　　处：《药品评价》2022年第19期1200-1202,共3页Drug Evaluation

基　　金：江西省卫生计生委中医药科研课题项目(2018A157)。

摘　　要：目的:观察补阳还五汤加减对股骨粗隆间骨折手术患者术后凝血功能及隐性失血的影响。方法:选择2020年1月至2021年12月期间医院收治股骨粗隆间骨折患者84例,依据随机数字表法将其分为两组,各42例。两组患者均行股骨近端防旋髓内钉(PFNA)内固定术治疗,对照组术后给予低分子量肝素钙抗凝,观察组在对照组基础上于术后第2天给予补阳还五汤加减治疗。比较两组术后当天、术后1周凝血功能,术前、术后1周红细胞压积(HCT)及隐性失血量。结果:术后1周两组凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、凝血酶时间(TT)均长于术后当天;纤维蛋白原(FIB),D-二聚体(D-D)低于术后当天,且观察组PT、APTT、TT长于对照组,FIB、D-D低于对照组,差异有统计学意义(P<0.05)。术后1周HCT低于术后当天,且观察组高于对照组,差异有统计学意义(P<0.05);观察组隐性失血量低于对照组,差异有统计学意义(P<0.05)。结论:补阳还五汤加减可改善股骨粗隆间骨折手术患者术后凝血功能,降低隐性失血量。Objective:To observe the effect of modified buyang huanwu decoction on postoperative coagulation function and hidden blood loss in patients with femoral intertrochanteric fractures.Methods:From January 2020 to December 2021,84 patients with femoral intertrochanteric fractures were selected and divided into two groups according to the random number table method,with 42 cases in each group.Both groups of patients were treated with proximal femoral anti-rotation intramedullary nail(PFNA)internal fixation,the control group was given low molecular weight heparin calcium anticoagulation after operation,and the observation group were given buyang huanwu decoction on the basis of control group on the 2nd day after operation.The blood coagulation function,hematocrit(HCT),and hidden blood loss before and 1 week after the operation were compared between the two groups.Results:One week after operation,the prothrombin time(PT),partially activated thromboplastin time(APTT)and thrombin time(TT)of the two groups were all longer than the day after operation,fibrinogen(FIB),D-dimer(D-D)was lower than the day after surgery,the PT,APTT,and TT in the observation group were longer than those in the control group,the FIB and D-D in the observation group were lower than those in the control group,with statistical significance(P<0.05).HCT at 1 week after surgery was lower than that on the day after surgery,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The hidden blood loss in the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion:Buyang huanwu decoction hypothyroidism can improve postoperative coagulation function and reduce hidden blood loss in patients with femoral intertrochanteric fracture surgery.

关 键 词：股骨骨折 补阳还五汤 凝血功能 隐性失血量 骨折固定术 髓内 

分 类 号：R274.1[医药卫生—中医骨伤科学]