当归补血汤化裁治疗老年股骨粗隆间骨折术后隐性失血随机对照研究OA

Objective To investigate the efficacy of Modified Danggui Buxue Decoction(MDBD)in elderly patients with occult blood loss after intertrochanteric femoral fracture treated by InterTAN intramedullary nailing.Methods A total of 96 elderly patients with occult blood loss after intertrochanteric femoral fracture admitted to Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2021 to December 2022 were randomly assigned into the observation group(48 cases)and the control group(48 cases).Both groups received InterTAN intramedullary nailing treatment,and the observation group was additionally given MDBD,with a follow-up of 3 months.The total blood loss,occult blood loss,and blood transfusion rate within 7 days after surgery were recorded.The levels of hemoglobin(Hb)and hematocrit(Hct)were measured on the 1st,3rd,and 7th days after surgery.The hip joint function was evaluated by the Harris Hip Score at 3 months postoperatively,and the clinical efficacy and incidence of complications were observed and recorded.Results Compared with the control group,the observation group showed reductions in total and occult blood loss at 7 days postoperatively(P＜0.01),and a lower transfusion rate(P＜0.05),levels of Hb and Hct increased at 3 and 7 days after surgery(P＜0.01).At the 3-month follow-up,the Harris Hip Score in the observation group was higher than that in the control group(P＜0.01).The total clinical effective rate in the observation group was 100.00％(48/48),which was higher than that in the control group 87.50％(42/48,x 2=4.444,P=0.035).Only 1 case of hemorrhagic anemia occurred in the observation group,with a complication rate of 2.08％(1/48),which was lower than that in the control group[16.67％(8/48),x2=4.414,P=0.036].Conclusions MDBD can effectively improve hematological indices and reduce the incidence of complications in elderly patients with intertrochanteric fractures treated with InterTAN who experience occult blood loss.