| Objective: To study the efficacy and safety of modified Shengxue Busui Decoctat ion in treating hidden hemorrhage after proximal femoral nail antirotation(PFNA)oper ation in elderly patients with intertrochanteric fracture in order to provide theoretical b asis for treatment of hidden hemorrhage after PFNA operation in elderly patients with intertrochanteric fracture by invigorating qi and blood and nourishing liver and kidne y.Methods: From Jan.2018 to Feb.2019,the elderly patients with intertrochanteric fracture treated by PFNA internal fixation were selected as the subjects in the Depart ment of Orthopaedics,our hospital.According to the principle of randomized control,the intertrochanteric fracture elderly patients who measured up to the inclusion criteria were divided into control group and trail group,30 cases in each group.Specific ther apy scheme for trail group: Shengxue Busui Decoction was orally administrated from a dmission to 2 days after operation.Control group: the control group was treated with the basic perioperative therapy as same as that of trial group while they were not giv en the Shengxue Busui Decoction.The changes of hemoglobin and hematocrit were o bserved on admission day,1 day before operation,1 and 2 days after operation.The b lood volume reduction before and after operation was calculated by GROSS equation f ollowing by the calculation of hidden hemarrhage.The changes of preoperative hidden hemarrhage,perioperative total blood loss,intraoperative dominant hemarrhage,intraope rative hidden hemarrhage,post-operative dominant hemarrhage,post-operative hidden h emarrhage,hemoglobin and hematocrit on admission day,1 day before operation,the 1st day and the 2nd day after operation as well as the hospitalization time were analy zed and compared between the two groups.And adverse events were recorded if any.Results: The control group consisted of 30 patients,including 13 males and 17 f emales,16 left and 14 right fractures,8 hypertension cases,4 diabetes mellitus cases,a nd 3 coronary atherosclerotic heart disease cases with an average age of 77.86(9.45),an average height of 1.652(0.037m),an average weight of 55.50(+4.45kg),body m ass index(BMI): 20.38(1.70).Hb on admission day : 114.30 ± 8.06,ALB on admiss ion:35.49(+3.08),Hct on admission day:0.312(0.047),operation duration:47.83 ± 23.55 min,pre-operative hospitalization time :4.0(4.3)days,hospitalization time :6.5(4.3)days.The trail group consisted of 30 patients,including 14 males and 16 females,11 left and 19 right fractures,10 hypertension cases,5 diabetes mellitus cases,and 2 co ronary atherosclerotic heart disease cases with an average age of 80.50±8.60,an aver age height of 1.633±0.042 m,an average weight of 53.36±5.04 kg,body mass index(B MI): 20.07(3.15).Hb on admission day 114.13 ± 7.84,ALB on admission:35.97 ± 3.06,preoperative Hct:0.327(0.039)and operation duration:43.20 ± 22.76 min,hospitaliza tion time before operation:5.4(3.0)days,hospitalization time:7.0(3.3)days.The baselin es of sex,height,weight,past medical history,AO classification of intertrochanteric fr acture,diagnosis time after fracture,hospitalization days before operation and operation time were compared between the two groups.The baseline was balanced(P > 0.05).Conclusion: Shengxue Busui Decoction has a significant effect on reducing the hi dden hemarrhage after proximal femoral nail antirotation(PFNA)operation in the elde rly patients with intertrochanteric fracture,which could reduce the total blood loss and total hidden hemarrage during perioperative period.No adverse reactions and complicat ions occurred during the study. |
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