活血化瘀方联合PFNA内固定对股骨粗隆间骨折患者髋关节功能和血流变学的影响

目的 探讨活血化瘀方联合股骨近端防旋髓内钉(PFNA)内固定治疗对股骨粗隆间骨折患者髋关节功能、血流变学的影响.方法 56例股骨粗隆间骨折患者随机分为试验组(n=28)和对照组(n=28).对照组实施PFNA内固定治疗,试验组术后联合活血化瘀方.统计并比较2组临床疗效和术后并发症;治疗前后评估2组髋关节功能,检测并比较2组血流变学指标变化.结果 试验组骨折端愈合时间、离床活动时间均显著早于对照组(P<0.05或P<0.01);试验组术后下肢深静脉血栓发生率明显低于对照组(P<0.05);试验组优良率显著高于对照组(P<0.05);与治疗前相比,治疗后2组全血高切黏度、全血低切黏度、红细胞刚性指数、血浆黏度、红细胞比容等血流变学相关指标水平均呈现明显的下降状态,红细胞变形指数与治疗前相比升高状态显著,且2组间差异显著(P<0.05或P<0.01).结论 活血化瘀方辅助PFNA内固定治疗股骨粗隆间骨折,可有效改善患者的临床症状,加快血流速度,缩短骨折端愈合时间,有助于其髋关节功能的提高.

Effect of Activating blood and resolving stasis Recipe combined with PFNA treatment on hip joint function and hemorheology in patients with intertrochanteric femoral fracture

Objective To investigate the effect of Activating blood and resolving stasis Recipe combined with proximal femoral nail (PFNA) in the treatment of intertrochanteric femoral fracture patients and its influence on hip joint function and hemorheology. Methods 56 patients with intertrochanteric femoral fracture were randomly divided into the experimental group and the control group, 28 patients in each group. The control group was used PFNA internal fixation treatment, the experimental group was treated with Activating blood and resolving stasis Recipe after treatment. The clinical efficacy and postoperative complications were compared between the 2 groups;to evaluate the function of hip joint in the 2 groups before and after treatment; the changes of hemorheology function were measured and compared between the 2 groups before and after treatment. Results The healing time and loading time in the experimental group were shorter than those in the control group (P < 0.05 or P < 0.01); The incidence of deep venous thrombosis in the experimental group was lower than that in the control group (P < 0.05); The excellent and good rate of the experimental group was higher than that of the control group (P < 0.05). After treatment, the whole blood (high and low shear ) viscosity, plasma viscosity, hematocrit, erythrocyte rigidity index of the 2 groupswere decreased compared before treatment, the erythrocyte deformation index was higher than before treatment, there was remarkable difference between the 2 groups (P < 0.05 or P < 0.01). Conclusion Activating blood and resolving stasis Recipe combined with PFNA internal fixation can effectively improve the clinical symptoms of intertrochanteric femoral fracture patients, accelerate blood flow velocity, shorten the healing time of fracture, and be helpful to improve the function of hip joint.