八珍汤治疗老年转子间骨折围手术期隐性失血临床研究

林适1，吴宇航1，何才勇 2 1.广州中医药大学第一临床医学院，广东 广州 510405；

2.广州中医药大学第一附属医院，广东 广州 510405

摘要：目的 探讨八珍汤治疗老年患者转子间骨折围手术期隐性失血的临床疗效及其对术后短期并发症的影响。方法 选择经股骨近端防旋髓内钉治疗的老年股骨转子间骨折患者87例，采用非随机对照试验设计分为治疗组 44例及对照组43 例。2组入院后常规予患肢胫骨结节牵引，控制高血压、糖尿病，抗炎镇痛，低分子肝素常规抗凝。治疗组在此基础上入院即予八珍汤，每日1剂，至出院前1 d。观察 2组围手术期总失血量、隐性失血量、输血情况、住院时长、短期并发症，检测血红蛋白（Hb）含量。结果 2组围手术期总出血量、

隐性失血量及住院时间比较，治疗组低于对照组，差异有统计学意义（P＜0.05）。治疗组无输血，对照组输血2例、总输血量9 个单位，2组总输血量比较差异有统计学意义（P＜0.05）。2组术后2 h 比较，Hb含量差异无统计学意义（P＞0.05）；2 组术后 12～24 h及术后5d比较，治疗组Hb含量高于对照组，差异有统计学意义（P＜0.05）。2 组短期并发症比较差异无统计学意义（P＞0.05）。结论 八珍汤可提高老年股骨转子间骨折围手术期患者Hb水平，降低隐性失血量及总失血量，有利于患者术后康复。关键词：八珍汤；隐性失血；转子间骨折；老年；临床疗效DOI：10.3969/j.issn.1005-5304.2018.11.003 中图分类号：R274.9 文献标识码：A 文章编号：1005-5304(2018)11-0010-05 Clinical Study on Treatment of Recessive Blood Loss After Operation of Intertrochanteric Fracture of Elderly with Bazhen Decoction LIN Shi1, WU Yu-hang1, HE Cai-yong2

1. The First Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China;

2. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China

Abstract: Objective To explore the clinical efficacy of hidden blood loss after operation of proximal femoral nail anti-rotation (PFNA) for intertrochanteric fracture of femur of the elderly with Bazhen Decoction; To discuss the effects on short-term complications after operation. Methods Totally 87 patients with intertrochanteric fracture treated with PFNA were included in the study. The non-randomized controlled trial design was used to divide them into treatment group (44 cases) and control group (43 cases). Both groups were routinely given traction of the affected limbs and tibia, controlled hypertension, diabetes, anti-inflammatory analgesia, and low molecular weight heparin routine anticoagulation. The treatment group was treated with Bazhen Decoction, one dosage per day, continuous administration to 1 day before discharge. The bleeding volume, blood transfusion volume, hemoglobin, length of stay and short-term complications were observed in the two groups. Results The perioperative bleeding, volume and hospitalization time of the treatment group were all lower than those of the control group, with statistical significance

(P<0.05). No patient needed blood transfusion in the treatment group, while two patients in the control group needed blood transfusion, with nine units. There was statistical significance between total blood transfusion volume in the two groups (P<0.05). There was no statistical significance in Hb level between the two groups 2 h after surgery (P>0.05). There was statistical significance in Hb level 12–24 h after surgery and 5 d after surgery between the two groups

(P<0.05). There was no statistical significance in short-term complications between the two groups (P>0.05).