温胆汤联合托烷司琼在股骨粗隆间骨折股骨近端防旋髓内钉内固定术后的应用效果  

Application effect of Wendan Decoction combined with Tropisetron after proximal femoral nail antirotation internal fixation in the treatment of intertrochanteric fracture of femur

作　　者：黄雪黎 李沂锚 王潼鑫 关可立 郑志辉 HUANG Xueli;LI Yimao;WANG Tongxin;GUAN Keli;ZHENG Zhihui(Department of Joint Orthopedics,Shantou Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine,Guangdong Province,Shantou 515000,China;Department of Joint Orthopedics,Shantou Traditional Chinese Medicine Hospital,Guangdong Province,Shantou 515000,China)

机构地区：[1]广州中医药大学附属汕头中医院关节骨科,广东汕头515000 [2]广东省汕头市中医医院关节骨科,广东汕头515000

出　　处：《中国当代医药》2025年第1期90-94,共5页China Modern Medicine

基　　金：广东省中医药局科研项目(20221370)。

摘　　要：目的探讨温胆汤联合托烷司琼对股骨粗隆间骨折股骨近端防旋髓内钉(PFNA)内固定术后恶心呕吐(PONV)的应用效果。方法选取2019年1月至2022年1月在汕头市中医医院行股骨粗隆间骨折PFNA内固定术的90例患者作为研究对象,采用随机数字表法分为温胆汤组、托烷司琼组、联合组,每组各30例。温胆汤组在术后当天开始静滴生理盐水100 ml,并于术后8 h开始服用温胆汤;托烷司琼组在术后当天开始静滴生理盐水100 ml+托烷司琼5 mg;联合组在术后当天开始静滴生理盐水100 ml+托烷司琼5 mg,并于术后8 h开始口服温胆汤。三组用药均维持至术后48 h。比较三组患者术后6、12、24、48 h的PONV发生率、疼痛发生率、镇静满意率,并比较三组的住院天数。结果三组患者6、12、24 h的PONV发生率比较,差异有统计学意义(P<0.05)。术后6 h,联合组与托烷司琼组的PONV发生率低于温胆汤组,差异有统计学意义(P<0.017);术后12、24 h,联合组的PONV发生率低于温胆汤组与托烷司琼组,差异有统计学意义(P<0.017)。术后48 h,三组患者的PONV发生率比较,差异无统计学意义(P>0.05)。三组患者术后6、12、24、48 h的疼痛发生率与镇静满意率比较,差异无统计学意义(P>0.05)。联合组的住院时间短于温胆汤组和托烷司琼组,差异有统计学意义(P<0.05)。结论温胆汤联合托烷司琼对防治股骨粗隆间骨折PFNA内固定术PONV效果较单用温胆汤或托烷司琼更佳,值得临床推广。Objective To explore the application effect of Wendan Decoction combined with Tropisetron on postoperative nausea and vomiting(PONV)after proximal femoral nail antirotation(PFNA)internal fixation for intertrochanteric fracture of femur.Methods A total of 90 patients who underwent PFNA internal fixation of intertrochanteric fracture of femur in Shantou Traditional Chinese Medicine Hospital from January 2019 to January 2022 were selected as the research objects.They were divided into Wendan Decoction group,Tropisetron group and combination group according to random number table method,with 30 cases in each group.The Wendan Decoction group was given Wendan Decoction 8 h after operation,and the normal saline 100 ml was given by intravenous drip on the day of operation.In the Tropisetron group,normal saline 100 ml and Tropisetron 5 mg were given by intravenous drip on the day of operation.In the combination group,normal saline 100 ml and Tropisetron 5 mg were given intravenously on the day of operation,and Wendan Decoction was given orally 8 hours after operation.The medication of the three groups was maintained until 48 h after operation.The incidence of PONV,the incidence of pain and the satisfaction rate of sedation at 6,12,24 and 48 h after operation were compared among the three groups,and the length of hospital stay was compared among the three groups.Results There were statistically significant differences in the incidence of PONV at 6,12 and 24 hours among the three groups(P<0.05).The incidence of PONV in the combination group and Tropisetron group were lower than that in the Wendan Decoction group 6 hours after surgery,and the differences were statistically significant(P<0.017).The incidence of PONV in the combination group was lower than those in the Wendan Decoction group and Tropisetron group 12 h and 24 h after surgery,and the differences were statistically significant(P<0.017).At 48 hours after operation,there was no significant difference in the incidence of PONV among the three groups(P>0.05).There wer

关 键 词：温胆汤 托烷司琼 股骨粗隆间骨折 股骨近端防旋髓内钉 术后恶心呕吐 

分 类 号：R683.42[医药卫生—骨科学]