铁剂治疗对老年股骨转子间骨折贫血及髋关节功能的疗效分析
|
摘要
目的探讨围术期口服铁剂对老年股骨转子间骨折贫血及髋关节功能恢复的影响,为临床治疗提供必要的参考依据。方法回顾性分析该院2012年3月至2016年5月采用股骨近端抗旋髓内钉(PFNA)内固定治疗的156例老年股骨转子间骨折患者的临床资料,按围术期是否规范口服琥珀酸亚铁治疗分为两组,对照组(80例)不使用铁剂,治疗组(76例)术后给予口服琥珀酸亚铁治疗12周。分别于术后1d、14d、1个月、3个月行血常规检查及术后髋关节功能(Sanders)评分,对两组患者围术期血红蛋白(Hb)量及髋关节功能进行评估。结果治疗组患者术后3个月Hb平均为(119.1±5.0)g/L,对照组为(102.5±5.6)g/L,治疗组Hb明显高于对照组,差异有统计学意义(P<0.05)。治疗组患者术后3个月Sanders评分平均为(55.3±3.5)分,对照组为(47.3±5.4)分,两组平均Sanders评分比较差异有统计学意义(P<0.05)。结论围术期口服铁剂治疗可以改善患者贫血和促进髋关节功能的恢复,缩短其康复周期,是有效、经济、安全的治疗方法。
Objective To investigate the impact of oral iron supplement on the anemia and hip joint function of elderly patients with intertrochanteric fracture in perioperative period,and to provide the necessary reference for clinical treatment.Methods A retrospective analysis was conducted on the clinical data of 156 elderly patients with intertrochanteric fracture,treated with proximal femoral nail antirotation(PFNA)internal fixation,in the hospital from March 2012 to May 2016.The patients were divided into two groups according to whether the patient had standard treatment of oral ferrous succinate.The control group(80 cases)did not use oral iron supplement,while the treatment group(76 cases)was given the oral treatment of ferrous succinate after operation for 12 weeks.Blood samples were taken from 1 day,14 days,1 month,3 months postoperatively and the Sanders score was used to evaluate the hemoglobin and hip function in the two groups.Results At three months postoperatively,the average Hb was(119.1±5.0)g/L in the treatment group,and(102.5±5.6)g/L in the control group.The level of Hb in the treatment group was significantly higher than that in the control group.The difference is statistically significant(P<0.05).At three months postoperatively,the average Sanders score was(55.3±3.5)in the treatment group,and(47.3±5.4)in the control group.The difference is statistically significant(P<0.05).Conclusion Oral iron therapy in perioperative period can improve anemia and promote the recovery of hip function,shorten the rehabilitation period of patients,which is an effective,economical and safe treatment.
Objective To investigate the impact of oral iron supplement on the anemia and hip joint function of elderly patients with intertrochanteric fracture in perioperative period,and to provide the necessary reference for clinical treatment.Methods A retrospective analysis was conducted on the clinical data of 156 elderly patients with intertrochanteric fracture,treated with proximal femoral nail antirotation(PFNA)internal fixation,in the hospital from March 2012 to May 2016.The patients were divided into two groups according to whether the patient had standard treatment of oral ferrous succinate.The control group(80 cases)did not use oral iron supplement,while the treatment group(76 cases)was given the oral treatment of ferrous succinate after operation for 12 weeks.Blood samples were taken from 1 day,14 days,1 month,3 months postoperatively and the Sanders score was used to evaluate the hemoglobin and hip function in the two groups.Results At three months postoperatively,the average Hb was(119.1±5.0)g/L in the treatment group,and(102.5±5.6)g/L in the control group.The level of Hb in the treatment group was significantly higher than that in the control group.The difference is statistically significant(P<0.05).At three months postoperatively,the average Sanders score was(55.3±3.5)in the treatment group,and(47.3±5.4)in the control group.The difference is statistically significant(P<0.05).Conclusion Oral iron therapy in perioperative period can improve anemia and promote the recovery of hip function,shorten the rehabilitation period of patients,which is an effective,economical and safe treatment.
引文
[1]陈远泽,杜云峰.高龄股骨粗隆间骨折股骨近端髓内钉-抗螺旋刀片治疗的临床体会[J].检验医学与临床,2012,9(24):3060-3061.
[2]Uzoigwe CE,Burnand HG,Cheesman CL,et al.Early and ultra-early surgery in hip fracture patients improves survival[J].Injury,2013,44(6):726-729.
[3]张峰,李涛,薛鹏.股骨近段带锁髓内钉治疗老年股骨转子间骨折[J].中国医刊,2008,43(8):58-59.
[4]Sehat KR,Evans R,Newman JH.How much blood is really lost in total knee arthroplasty?Correct blood loss management should take hidden loss into account[J].Knee,2000,7(3):151-155.
[5]金宇恒,杨光,郝玉刚,等.LPFP和PFNAⅡ治疗老年股骨粗隆间粉碎性骨折的比较[J].中国中医骨伤杂志,2014,22(11):54-55.
[6]邓海峰,胡思斌,郑继会,等.PFNA内固定治疗股骨粗隆间骨折术后隐性失血的影响因素[J].中国骨与关节损伤杂志,2013,28(8):766-767.
[7]贾晓龙,顾始伟,李永正,等.DHS治疗EvansⅠ-Ⅳ型股骨粗隆间骨折围手术期隐性失血的临床回顾性研究[J].中国骨与关节损伤杂志,2012,27(6):529-530.
[8]陆燕,蔡攀,汤明荣,等.围术期输血治疗对老年股骨转子间骨折隐性失血的影响[J].检验医学与临床,2013,10(16):2086-2089.
[9]王宇仁,杨越华,倪斌斌.促红细胞生成素对改善股骨转子间骨折术后贫血的作用[J].临床骨科杂志,2014,17(5):489-492.
[10]Prasad N,Rajamani V,Hullin D,et al.Post-operative anaemia in femoral neck fracture patients:does it need treatment?A single blinded prospective randomised controlled trial[J].Injury,2009,40(10):1073-1076.
[11]Lawrence VA,Silverstein JH,Cornell JE,et al.Higher Hb level is associated with better early functional recovery after hip fracture repair[J].Transfusion,2003,43(12):1717-1722.
[2]Uzoigwe CE,Burnand HG,Cheesman CL,et al.Early and ultra-early surgery in hip fracture patients improves survival[J].Injury,2013,44(6):726-729.
[3]张峰,李涛,薛鹏.股骨近段带锁髓内钉治疗老年股骨转子间骨折[J].中国医刊,2008,43(8):58-59.
[4]Sehat KR,Evans R,Newman JH.How much blood is really lost in total knee arthroplasty?Correct blood loss management should take hidden loss into account[J].Knee,2000,7(3):151-155.
[5]金宇恒,杨光,郝玉刚,等.LPFP和PFNAⅡ治疗老年股骨粗隆间粉碎性骨折的比较[J].中国中医骨伤杂志,2014,22(11):54-55.
[6]邓海峰,胡思斌,郑继会,等.PFNA内固定治疗股骨粗隆间骨折术后隐性失血的影响因素[J].中国骨与关节损伤杂志,2013,28(8):766-767.
[7]贾晓龙,顾始伟,李永正,等.DHS治疗EvansⅠ-Ⅳ型股骨粗隆间骨折围手术期隐性失血的临床回顾性研究[J].中国骨与关节损伤杂志,2012,27(6):529-530.
[8]陆燕,蔡攀,汤明荣,等.围术期输血治疗对老年股骨转子间骨折隐性失血的影响[J].检验医学与临床,2013,10(16):2086-2089.
[9]王宇仁,杨越华,倪斌斌.促红细胞生成素对改善股骨转子间骨折术后贫血的作用[J].临床骨科杂志,2014,17(5):489-492.
[10]Prasad N,Rajamani V,Hullin D,et al.Post-operative anaemia in femoral neck fracture patients:does it need treatment?A single blinded prospective randomised controlled trial[J].Injury,2009,40(10):1073-1076.
[11]Lawrence VA,Silverstein JH,Cornell JE,et al.Higher Hb level is associated with better early functional recovery after hip fracture repair[J].Transfusion,2003,43(12):1717-1722.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |