中药三期辨证配合手术治疗老年股骨转子间骨折的临床疗效观察

发布时间：2018-03-29 22:09

本文选题：股骨转子间骨折　切入点：中药三期辩证　出处：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:观察中药三期辨证配合手术治疗老年股骨转子间骨折的临床疗效,从而为股骨转子间骨折的老年患者提供更优秀的治疗方案,取得更满意的治疗效果。方法:选取2014年1月至2015年1月期间在沈阳市骨科医院综合外科住院治疗的59例诊断为“股骨转子间骨折”的患者作为研究对象,59例患者年龄均≥65岁,其中中药组31例,非中药组28例,两组研究患者在性别、年龄、骨折分型以及合并症方面均无明显差异(P0.05)。59例患者按入院时间先后排序,随机分成两组,中药组在术后通过活血化瘀、续筋接骨、补肾健骨中药三期辨证用药配合手术治疗;而非中药组则按常规方式单纯行手术治疗,术后使用抗生素预防量预防感染,低分子肝素钙卧床期间预防下肢静脉血栓,常规手术切口换药。对比两组患者骨折愈合时间和术后1个月、3个月、6个月、12个月时的髋关节功能评分,同时应用医学统计学对比分析两组疗效。结果:共计59例患者手术后有12个月的随访期,中药组骨折愈合时间(12.58±1.62)w,非中药组骨折愈合时间(17.07±1.70)w;中药组术后1个月髋关节功能评分(66.39±3.25),非中药组术后1个月髋关节功能评分(59.79±2.77);中药组术后3个月髋关节功能评分(78.48±2.66),非中药组术后3个月髋关节功能评分(71.46±2.87);中药组术后6个月髋关节功能评分(89.22±2.11),非中药组术后6个月髋关节功能评分(81.43±3.18);中药组术后12个月髋关节功能评分(96.13±1.94),非中药组术后12个月髋关节功能评分(88.46±2.38)。两组比较骨折愈合时间和髋关节功能评分,差异有统计学意义(P0.05)。结论:对于股骨转子间骨折的治疗,中药三期辨证配合手术治疗相比于单纯手术治疗,有骨折愈合时间短,术后髋关节功能恢复好的优势,值得临床推广应用。
[Abstract]:Objective: to observe the clinical effect of the treatment of intertrochanteric fracture of the femur in the aged patients with the third stage differentiation of symptoms and signs of traditional Chinese medicine, so as to provide a better treatment scheme for the elderly patients with intertrochanteric fracture of the femur. Methods: 59 patients diagnosed as "intertrochanteric fracture of femur" were selected from January 2014 to January 2015 for general surgical treatment in Shenyang Orthopaedic Hospital. The age of all patients was more than 65 years old, There were 31 cases in Chinese medicine group and 28 cases in non-Chinese medicine group. There was no significant difference in sex, age, fracture classification and complications between the two groups. 59 patients were randomly divided into two groups according to the time of admission. The traditional Chinese medicine group was treated by promoting blood circulation and removing blood stasis after operation, followed by gluten and bone, and the third stage of tonifying kidney and strengthening bone Chinese medicine combined with surgical treatment; while the non-traditional Chinese medicine group was treated simply by operation in the routine way, and the amount of antibiotics used to prevent infection after operation was used to prevent infection. Low molecular weight heparin calcium (LMWHC) was used to prevent venous thrombosis in lower extremity during bed rest, and routine incision dressing was used to compare the fracture healing time and hip function score at 1 month, 3 months, 6 months and 12 months after operation in both groups. Results: a total of 59 patients were followed up for 12 months after operation. The fracture healing time of the Chinese medicine group was 12.58 卤1.62wand that of the non-Chinese medicine group was 17.07 卤1.70w.The hip function score of the Chinese medicine group was 66.39 卤3.25m at one month after operation, and that of the non-Chinese medicine group was 59.79 卤2.770.The hip joint function score of the traditional Chinese medicine group was 78.48 卤2.66g at 3 months after operation. The score of hip function was 71.46 卤2.87m in the non-Chinese medicine group, 89.22 卤2.11g in the traditional Chinese medicine group and 81.43 卤3.18m in the non-Chinese medicine group at 6 months postoperatively, and the hip function score was 96.13 卤1.94m in the traditional Chinese medicine group 12 months after operation, while in the non-Chinese medicine group, the hip joint function score was 96.13 卤1.94g / 12 months after operation. The hip function score was 88.46 卤2.38 卤88.46 卤2.38 at 12 months after operation. The fracture healing time and hip function score were compared between the two groups. Conclusion: for the treatment of intertrochanteric fracture of femur, three stages of TCM combined with surgical treatment have the advantages of shorter healing time and better recovery of hip joint function than that of simple surgical treatment. It is worth popularizing and applying in clinic.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.3

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