摘要
目的:目的:观察三七丹参片促进股骨颈骨折术后骨折愈合、预防股骨头坏死的疗效,探讨一种更为有效的辅助治疗方法。方法:收集1998年9月~2010年6月期间在昆明医学院第一附属医院骨科收治的股骨颈骨折内固定术后患者120例(男性52例,女性68例)。均为单侧股骨颈骨折。致伤原因:跌伤53例,车祸伤:29例,高处坠落伤:20例,重物砸伤:18例。Garden分型:Ⅰ型:40例,Ⅱ型:64例,Ⅲ型:16例,受伤至就诊时间最短30min,最长6d。大多数于伤后2d内就诊,均于伤后2h^7d内手术。手术方式均为牵引复位后微创经皮空心螺纹钉内固定。术后随机分为三七丹参片组和对照组。住院时间7~15d,平均12d,于术后第3天开始口服三七丹参片,成人3片/次,3次/d,连服3个月。后改为2片/次,2次/d,连服3个月,术后随访半年~9年,并采用股骨头坏死的评分标准及髋关节Harris评分标准对患者进行评分及统计学分析。结果:口服三七丹参片组与对照组通过比较差异有统计学意义,表明三七丹参片可促进股骨颈骨折术后骨折愈合,并能预防股骨头坏死。结论:对无明显移位的股骨颈骨折采用闭合复位空心螺纹钉内固定,术后配合口服三七丹参片可有效促进骨折愈合并预防股骨头坏死的发生。
Objective： To observe the preventing effects of the femoral head necrosis after the operation of femoral neck fracture by taking sanqidanshen tablets.Methods：A total of 120 patients（male：52 cases;female：68 cases） with the femoral neck fracture operated with the internal fixation were selected from Department of Orthopedic Surgery of the First Affiliated Hospital of Kunming Medical university from September 1998 to June 2010.The femoral neck fractures were occurred in only one hip in all of the patients.The causes of femoral neck fracture were falling injury in 53 cases,road accident injury in 29cases,homo-crash injury in 20 cases;smash injury in 18 cases.40 cases were typeⅠ,according to the Garden classification;64 cases were typeⅡ;16 cases were type Ⅲ;Complicated with hypertension in 13 cases;Complicated with diabetes in 9 cases.Complicated with heart disease in 5 cases;Complicated with cerebrovascular disease（CVD） in 4 cases;Complicated with liver and kidney function attenuated in 1case;The time from injury to hospital was from 30 minutes to 6 days.The most patients went sent to hospital within 2 days and were operated from 2 hours to 7 days.All the patients were operated with the hollow screw fixed internally after traction reduction.The Length of Stay was from 7d to 15d,the average was 12d.The length of follow-up was ranged from 6 months to 9 years.They were randomly divided into two groups：one was the group of taking tablets;the other was the control group.Sanqidanshen was taken on the third day after operation.3 tablets were swallowed at one time for adult,with mild boiled water after meal for 30 minutes,3 times a day,and keeping this way for 3 months continuously,and then only 2 tablets were swallowed at one time,2 times a day and continued to take the medicine for another 3 months.The score were collected according to the standard of femoral head necrosis formulated in the first national conference of osteonecrosis and the Harris score standard of hip joint.These results were analyzed by SPSS software.Results：The two groups have significant difference according to the standard of femoral head necrosis（χ2=6.358χ20.025（1,P0.025）,There were significant differences between the two groups,and this showed that Sanqidanshen could promote the fracture of femoral neck to recover and avoid the necrosis of the femoral head.Conclusion：The patients who suffered from the fracture of femoral neck without obvious dislocation should be given closed reduction with the hollow screw for internal fixation as the first treatment.Moreover,taking sanqidanshen tablets after operation could effectively avoid the necrosis of femoral head.
出处
《中国中医骨伤科杂志》
CAS
2011年第6期12-14,17,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
云南省自然科学基金项目(No.2005C0070M)
昆明医学院第一附属医院院内科研项目(No.2004KJT07)资助
关键词
三七丹参片股骨颈骨折
内固定
股骨头坏死
Sanqidansheng tablets
femoral neck fracture
internal fixation
the necrosis of femoral head
