中药“人参养荣汤”结合人工关节置换治疗股骨颈骨折内固定失败疗效观察  

Clinical Observation on the Treatment of Internal Fixation Failure of Neck of Femur Fracture with Renshen Yangrong Decoction Combined with Artificial Joint Replacement

作　　者：刘波 Liu Bo(Department of Orthopedics,Sichuan Hospital of Integrated Traditional Chinese and Western Medicine,Chengdu 610041,China)

机构地区：[1]四川省中西医结合医院骨科,四川成都610041

出　　处：《亚太传统医药》2024年第8期99-103,共5页Asia-Pacific Traditional Medicine

基　　金：四川省干部保健科研课题(川干研2021-1403)。

摘　　要：目的:观察人工髋关节置换结合口服中药治疗股骨颈骨折内固定失败患者的临床疗效。方法:选择2020年5月至2023年5月25例股骨颈骨折内固定失败的患者,这些患者均通过口服中药结合人工髋关节置换来进行治疗的,根据中医理论-骨折三期辨证为基础,骨折长时间不愈合,病程较长,则会耗气伤津,肝肾功能受损,治法上选择调补肝肾、充养气血,采用人参养荣汤加减口服。其中男13例,女12例;年龄42~85岁,平均63.7岁;左髋病例数共12例,右髋病例数共13例。这些患者在平均25.1个月(2个月~2年)间隔时间内行了两次手术。结果:本组纳入病例为25例,其中采用生物杯直接固定为17例,先对病例进行植骨修复缺损再采用生物杯固定的有7例,有1例先行植骨修复缺损钛网杯固定再使用骨水泥臼杯固定的,其中有12例患者采用了股骨柄生物型柄,有13例则采用了骨水泥柄。无术中并发症发生,手术平均时间120 min,出血量平均550 mL,输血量平均500 mL,平均术中补液量2400 mL,术后早期脱位1例。术后6~25个月(平均15.1个月)为本次入组患者的随访时间,本组病例术后情况良好,所有术后切口均无红肿渗液,所植入假体均无下陷、松动的表现,未超过远端螺钉孔的假体长度,此类患者也无二次发生应力骨折,Harris评分平均89.3分(术前39.8分)。结论:中药“人参养荣汤”结合人工关节置换治疗股骨颈骨折内固定失败患者,可使患者在术后早期下地活动锻炼,缩短卧床时间,能更好地预防卧床并发症,对患者近期的康复有良好的临床效果,而对于远期疗效,则需要进一步临床验证。Objective:To observe the clinical efficacy of artificial hip replacement combined with oral Chinese medicine in the treatment of failed internal fixation of neck of femur fracture.Methods:From May 2020 to May 2023,25 patients with failed internal fixation of neck of femur fractures were selected.These patients were treated by oral Chinese medicine combined with artificial hip replacement.According to the theory of traditional Chinese medicine-three stages of syndrome differentiation of fractures,if the fracture did not heal for a long time and the course of disease was longer,it would consume gas and hurt fluid,and the liver and kidney functions would be damaged.The treatment method was to adjust and replenish the liver and kidney,replenish Qi and blood,and take Renshen Yangrong Decoction plus or minus orally.Among them,there are 13 males and 12 females;Age range from 42 to 85 years,with an average age of 63.7 years;There are a total of 12 cases in the left hip and 13 cases in the right hip.These patients underwent two surgeries within an average interval of 25.1 months(2 months to 2 years).Results:There were 25 cases included in this group,of which 17 were directly fixed with a biological cup.Seven cases underwent bone grafting to repair the defect and then fixed with a biological cup.One case underwent bone grafting to repair the defect and then fixed with a titanium mesh cup and a bone cement mortar cup.Among them,12 patients used a femoral stem biological handle,while 13 patients used a bone cement handle.No intraoperative complications occurred.The average surgical time was 120 minutes,with an average bleeding volume of 550mL,an average blood transfusion volume of 500mL,and an average intraoperative fluid replacement volume of 2400mL.There was 1 case of early postoperative dislocation.The follow-up period for this enrolled patient was 6-25 months(average 15.1 months)after surgery.The postoperative condition of this group of patients was good,with no redness,swelling,or fluid leakage in all postoperative inci

关 键 词：人参养荣汤 人工髋关节置换 股骨颈骨折 内固定失败 

分 类 号：R274[医药卫生—中医骨伤科学]