半夏厚朴汤加减联合高压氧防治老年髋部骨折术后谵妄及认知功能障碍的疗效  

作　　者：郑杨[1] 石月杰[1] 王碧 陈扬 

机构地区：[1]浙江省中医院,310003 [2]杭州市富阳中医骨伤医院,311400

出　　处：《浙江临床医学》2023年第9期1349-1350,1353,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省中医药科技计划项目(2022ZB112)。

摘　　要：目的探讨半夏厚朴汤加减联合高压氧对防治老年髋部骨折术后认知障碍(POCD)及术后谵妄(POD)的疗效。方法164例老年髋部骨折术后患者随机分为观察组与对照组,每组各82例。对照组给予髋部骨折围术期常规治疗。观察组在对照组基础上给予高压氧及口服半夏厚朴汤加减治疗。观察两组患者临床症状,采用简易智力状态量表(MMSE)评定患者POCD情况,采用老年谵妄测验(CAM-CR)评估患者POD情况。结果观察组POCD发生率、中重度比例以及MMSE评分与对照组比较差异有统计学意义(P<0.05),观察组POD发生率及CAM-CR评分与对照组比较差异有统计学意义(P<0.05)。结论半夏厚朴汤加减联合高压氧能有效防治老年髋部骨折POCD及POD的发生率并降低严重程度。Objective To explore the efficacy of Banxia-Houpu Decoction combined with hyperbaric oxygen in the prevention and treatment of postoperative cognitive dysfunction(POCD)and postoperative delirium(POD)in elderly patients with hip fracture.Methods 164 patients after postoperative hip fracture were randomly divided into the test group and the control group,82 cases in each group.The control group was given routine treatment for hip fracture.The test group received routine treatment and Banxia-Houpu Decoction combined with hyperbaric oxygen treatment 1 day before operation and 1-14 days after operation.The clinical symptoms of both groups were observed,Mini‐Mental State Examination(MMSE)and Confusion Assessment Method-Chinese Reversion(CAM-CR)was evaluated for POCD and POD,respectively.Results The incidence of POCD,the proportion of moderate and severe cases and the MMSE scores in the test group were significantly better than those in the control group(P<0.05).And the incidence of POD and CAM-CR scores in the test group were significantly better than those in the control group(P<0.05).Conclusion The combination of Banxia-Houpu Decoction and hyperbaric oxygen can effectively prevent the incidence of POCD and POD in elderly hip fractures and reduce the severity.

关 键 词：半夏厚朴汤 高压氧 老年 髋部骨折 术后认知功能障碍 术后谵妄 

分 类 号：R687.3[医药卫生—骨科学]