[1]董根荣,陈龙,何斌,等.加味桃红四物汤对老年股骨转子间骨折股骨近端防旋髓内钉内固定术围手术期隐性失血的影响[J].中医正骨,2017,29(09):12-14，22.
　DONG Genrong,CHEN Long,HE Bin,et al.Influence of Jiawei Taohong Siwu Tang(加味桃红四物汤)on perioperative hidden blood loss in aged patients who received proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(09):12-14，22.
点击复制

加味桃红四物汤对老年股骨转子间骨折股骨近端防旋髓内钉内固定术围手术期隐性失血的影响()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年09期
页码:
12-14，22
栏目:
临床研究
出版日期:
2017-09-20

文章信息/Info

Title:
Influence of Jiawei Taohong Siwu Tang(加味桃红四物汤)on perioperative hidden blood loss in aged patients who received proximal femoral nail antirotation internal fixation for femoral intertrochanteric fractures
作者:
董根荣; 陈龙; 何斌; 尧彦青; 沈卫东
浙江省湖州市南浔区人民医院,浙江 湖州 313009
Author(s):
DONG Genrong; CHEN Long; HE Bin; YAO Yanqing; SHEN Weidong
Nanxun People's Hospital of Huzhou City,Huzhou 313009,Zhejiang,China
关键词:
失血; 手术;  隐性失血;  髋骨折;  桃红四物汤;  骨折固定术; 髓内;  股骨近端防旋髓内钉;  静脉血栓形成;  临床试验
Keywords:
Key words blood loss; surgical;  hidden blood loss;  hip fractures;  Taohong Siwu Tang;  fracture fixation; intramedullary;  proximal femoral nail antirotation;  venous thrombosis;  clinical trial
摘要:
目的:探讨围手术期应用加味桃红四物汤对老年股骨转子间骨折股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)内固定术围手术期隐性失血的影响及其安全性。方法:将78例老年股骨转子间骨折患者随机分为加味桃红四物汤组(38例)和常规治疗组(40例)。所有患者均由同一组医生完成PFNA内固定手术,术后12 h开始皮下注射低分子量肝素注射液,每天1次,连用7 d。加味桃红四物汤组自入院2 h后即口服加味桃红四物汤,直至术后第7 天,手术日停服1次。常规治疗组除不口服加味桃红四物汤外,其余治疗均与加味桃红四物汤组相同。测定2组患者的失血量,术后7 d时通过超声检查观察下肢静脉血栓形成情况。结果:加味桃红四物汤组的失血总量和术后隐性失血量均低于常规治疗组[(1 240.0±297.0)mL,(1 475.0±300.0)mL,t=-124.637,P=0.000;(797.0±290.0)mL,(988.0±288.0)mL,t=-80.898,P=0.000]; 2组患者显性失血量和术前隐性失血量比较,组间差异均无统计学意义[(359.0±65.0)mL,(357.0±58.0)mL,t=1.698,P=0.000;(157.0±41.3)mL,(159.0±40.4)mL,t=-1.829,P=0.068]。术后7 d时常规治疗组1例患者出现股静脉栓塞,加味桃红四物汤组未发现下肢静脉血栓。2组患者的下肢静脉血栓发生率比较,差异无统计学意义(P=1.000)。结论:围手术期应用加味桃红四物汤可有效减少老年股骨转子间骨折PFNA内固定术围手术期隐性失血,并且具有较高的安全性。
Abstract:
ABSTRACT Objective:To explore the influence of Jiawei Taohong Siwu Tang(加味桃红四物汤,JWTHSWT)on perioperative hidden blood loss in aged patients who received proximal femoral nail antirotation(PFNA)internal fixation for femoral intertrochanteric fractures and its safety.Methods:Seventy-eight aged patients with femoral intertrochanteric fractures were randomly divided into JWTHSWT group(38 cases)and conventional therapy group(40 cases).All patients were treated with PFNA internal fixation by the same group of surgeons and with subcutaneous injection of low-molecular-weight heparin since the 12th hour after the surgery,once a day for consecutive 7 days.Meanwhile,the patients in JWTHSWT group were treated with oral application of JWTHSWT from the 2nd hour after hospitalization admission till postoperative day 7 except on the day of surgery.The blood loss were measured and compared between the 2 groups,and the incidences of lower limb venous thrombosis were also observed through ultrasonic examination on postoperative day 7.Results:The total blood loss and postoperative hidden blood loss were lower in JWTHSWT group compared to conventional therapy group(1 240.0+/-297.0 vs 1 475.0+/-300.0 ml,t=-124.637,P=0.000; 797.0+/-290.0 vs 988.0+/-288.0 ml,t=-80.898,P=0.000).There was no statistical difference in dominant blood loss and preoperative hidden blood loss between the 2 groups(359.0+/-65.0 vs 357.0+/-58.0 ml,t=1.698,P=0.000; 157.0+/-41.3 vs 159.0+/-40.4 ml,t=-1.829,P=0.068).The femoral venous embolism(1 case)were found on postoperative day 7 in conventional therapy group,and no lower limb venous thrombosis was found in JWTHSWT group.There was no statistical difference in the incidence rate of lower limb venous thrombosis between the 2 groups(P=1.000).Conclusion:Oral application of JWTHSWT in perioperative period can effectively reduce the perioperative hidden blood loss in aged patients who received PFNA internal fixation for femoral intertrochanteric fractures,and it has high safety.

参考文献/References:

[1] 龙秋平,廖前德,尹科,等.股骨转子间骨折两种置入内固定的隐性失血比较[J].中国组织工程研究,2013,17(30):5460-5465. [2] 冯刚,潘志军,叶有晨.股骨转子间骨折围手术期隐性失血的比较研究[J].中华骨科杂志,2012,32(7):648-653. [3] JENSEN JS,SONNE-HOLM S,TNDEVOLD E.Unstable trochanteric fractures.A comparative analysis of four methods of internal fixation[J].Acta Orthop Scand,1980,51(6):949-962. [4] 国家中医药管理局.中医病症诊断疗效标准[M].南京:南京大学出版社,1994:170. [5] GROSS JB.Estimating allowable blood loss:corrected for dilution[J].Anesthesiology,1983,58(3):277-280. [6] NADLER SB,HIDALGO JH,BLOCH T.Prediction of blood volume in normal human adults[J].Surgery,1962,51(2):224-232. [7] 孙群周,阮成群,李光明,等.股骨近端防旋髓内钉内固定治疗老年不稳定型股骨转子间骨折[J].中医正骨,2015,10(10):20-21. [8] 张磊,柴浩.股骨近端髓内钉与动力髋螺钉固定治疗老年股骨转子间骨折的系统评价[J].中医正骨,2015,3(3):27-31. [9] PATTISON E,PROTHEROE K,PRINGLE RM,et al.Reduction in haemoglobin after knee joint surgery[J].Ann Rheum Dis,1973,32(6):582-584. [10] ERSKINE JG,FRASER C,SIMPSON R,et al.Blood loss with knee joint replacement[J].J R Coll Surg Edinb,1981,26(5):295-297. [11] MCMANUS KT,VELCHIK MG,ALAVI A,et al.Non-invasive assessment of postoperative bleeding in TKA patients with Tc-99m RNCs[J].Inucl Med,1987,28:565-568. [12] 朱云森,江敞,李俊.氨甲环酸对老年股骨转子间骨折髓内固定术围手术期隐性失血的影响[J].中医正骨,2015,6(6):16-18. [13] 雷金来,丛雨轩,庄岩,等.术前应用氨甲环酸对股骨近端防旋髓内钉固定治疗股骨转子间骨折隐性失血的影响[J].中华创伤骨科杂志,2017,19(2):103-108. [14] HUANG F,WU D,MA G,et al.The use of tranexamic acid to reduce blood loss and transfusion in major orthopedic surgery:a meta-analysis[J].J Surg Res,2014,186(1):318-327. [15] 程涛,黄家骏.中药内服治疗急性软组织损伤的研究进展[J].中医正骨,2017,29(1):39-41. [16] 赵佳盛,张耘.桃红四物汤治疗兔早期筋膜间隔综合征的疗效观察及作用机制研究[J].中医正骨,2015,4(4):1-7.

相似文献/References:

[1]易春智,陈锦伦,李肇宏,等.利伐沙班与依诺肝素钠对髋膝关节置换术后 下肢深静脉血栓形成及围手术期隐性失血的影响[J].中医正骨,2016,28(01):17.
　YI Chunzhi,CHEN Jinlun,LI Zhaohong,et al.Influence of Rivaroxaban and enoxaparin sodium on lower extremity deep venous thrombosis after total hip&knee arthroplasty and perioperative hidden blood loss[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(09):17.
[2]王庆东,李付彬,徐向峰,等.氨甲环酸术前静脉滴注联合术中关节内注射对 全膝关节置换术围手术期失血量的影响[J].中医正骨,2016,28(01):24.
　WANG Qingdong,LI Fubin,XU Xiangfeng,et al.Effect of preoperative intravenous drip infusion and intraoperative intra-articular injection of tranexamic acid on perioperative blood loss of total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(09):24.
[3]申震,韩文朝,王晓冰,等.氨甲环酸关节腔注射联合三七散口服对初次全膝关节置换术围手术期失血量的影响[J].中医正骨,2017,29(10):40.
　SHEN Zhen,HAN Wenchao,WANG Xiaobing,et al.Effect of intra-articular injection of tranexamic acid combined with oral application of panax notoginseng powders on perioperative blood loss in patients who received primary total knee arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(09):40.
[4]郑嘉晖,张津杰,金敏伟,等.氨甲环酸在全膝关节置换术中的应用…[J].中医正骨,2017,29(12):43.
[5]史超,姚啸生.老年股骨转子间骨折隐性失血的研究进展[J].中医正骨,2018,30(11):60.
[6]钱涛,夏永法.老年全髋关节置换术中联合应用氨甲环酸和利伐沙班的临床研究[J].中医正骨,2019,31(01):10.
　QIAN Tao,XIA Yongfa.A clinical study of combined application of tranexamic acid and rivaroxaban in total hip arthroplasty in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(09):10.
[7]吴晗,白文艺,程文丹,等.直接前入路与后外侧入路全髋关节置换术围手术期隐性失血量的比较研究[J].中医正骨,2019,31(09):7.
　WU Han,BAI Wenyi,CHENG Wendan,et al.A comparative study of perioperative hidden blood loss in patients who received total hip arthroplasty through direct anterior approach versus posterolateral approach[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(09):7.
[8]朱云森,江敞,李俊.氨甲环酸对老年股骨转子间骨折髓内固定术 围手术期隐性失血的影响[J].中医正骨,2015,27(06):16.
　ZHU Yunsen,JIANG Chang,LI Jun.Effect of tranexamic acid on perioperative hidden blood loss in aged patients receiving intramedullary fixation for treatment of intertrochanteric fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(09):16.

备注/Memo

备注/Memo:
通讯作者:董根荣 E-mail:dgr3068078@163.com
更新日期/Last Update: 2018-02-23