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| 血栓通对股骨颈骨质疏松性骨折患者置换术后血液高凝状态、骨代谢和康复进程的影响 |
| Effect of Xueshuantong on blood hyper-coagulability, bone metabolism, and rehabilitation process in osteoporotic patients with replacement therapy after femoral neck fractures |
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| DOI：10.3969/j.issn.1006.7108.2019.09.021 |
| 中文关键词: 股骨颈骨质疏松性骨折 血栓通注射液 凝血指标 骨代谢 |
| 英文关键词:osteoporotic fracture of the femoral neck Xueshuantong injection coagulation index bone metabolism |
| 基金项目:重庆市教委资助项目(KJ112522） |
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| 中文摘要: |
| 目的 探讨血栓通注射液对股骨颈骨质疏松性骨折患者置换术后血液高凝状态、骨代谢和康复进程的影响。方法 将2014年1月至2017年12月行人工髋关节置换术的股骨颈骨质疏松性骨折患者124例随机分为实验组和对照组，每组各62例，对照组术后给予常规治疗，实验组在对照组基础上加用血栓通注射液，两组均连续用药14 d。记录两组住院时间、完全负重下床活动时间，术前及术后14 d、3个月的Harris评分、视觉模拟评分（VAS），和术前及术后14 d检测凝血指标、血液流变学指标、骨代谢指标，并统计术后14 d 下肢静脉血栓形成（DVT）及出血并发症发生率。结果 实验组完全负重下床活动时间短于对照组（P＜0.05）；实验组术后14 d 、3个月 Harris评分高于对照组，VAS评分低于对照组（P＜0.05）；实验组术后14 d 血栓素B2（TXB2）、D-二聚体（D-D）、纤维蛋白原（FIB）及全血比高切黏度、全血比低切黏度、血浆比黏度均低于对照组（P＜0.05）；实验组术后 14 d骨钙素N端中分子片段（N-MID）、Ⅰ型前胶原氨基端前肽（PⅠNP）高于对照组，β-胶原降解产物（β-CTX）低于对照组（P＜0.05）；两组术后DVT及出血并发症发生率比较，差异无统计学意义（P＞0.05）。结论 股骨颈骨质疏松性骨折患者置换术后给予血栓通辅助治疗，可改善血液流变学及血液高凝状态，调整骨代谢，有利于缩短康复进程。 |
| 英文摘要: |
| Objective To investigate the effect of Xueshuantong injection on blood hyper-coagulability, bone metabolism, and rehabilitation process of patients with replacement therapy after osteoporotic fractures of the femoral neck. Methods 124 patients with osteoporotic fracture of the femoral neck who were treated with artificial hip replacement from January 2014 to December 2017 were selected as study subjects. They were randomly divided into experimental group and control group, with 62 patients in each group. Patients in the control group received conventional treatment after the surgery. On this basis, patients in the experimental group received Xueshuantong injection. The treatment in both groups continued for 14 days. The length of hospital stay and the time of complete weight-bearing out-of-bed activities were recorded. Harris scores and visual analogue scale (VAS) scores were recorded before surgery and at 14 days and 3 months after surgery. Coagulation indexes, hemorheology indexes, and bone metabolism indexes were detected before surgery and at 14 days after surgery. The incidence rates of lower extremity deep venous thrombosis (DVT) and bleeding complications on 14 days after surgery were counted. Results The time of complete weight-bearing out-of-bed activities of the experimental group was shorter than that of the control group (P<0.05). The Harris scores of experimental group were higher than those of the control group at 14 days and 3 months after surgery, and the VAS scores were lower than those of the control group (P<0.05). The TXB2, DD, FIB, whole blood high shear viscosity, whole blood low shear viscosity, and plasma viscosity in the experimental group at 14 days after surgery were lower than those in the control group (P<0.05). The N-MID and PINP in the experimental group at 14 days after surgery were higher than those in the control group, but β-CTX was lower than that in the control group (P<0.05). There was no significant difference in the incidence of DVT or bleeding complications between the two groups after surgery (P>0.05). Conclusion The adjuvant treatment of Xueshuantong for patients with replacement therapy osteoporotic after fractures of the femoral neck can improve hemorheology and blood hyper-coagulability, regulate bone metabolism, and shorten the rehabilitation process. |
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