| 蒋 科,向 超,王 勇,蒲朝宇,张建光.独圣活血片联合微创单一手术入路在股骨头坏死治疗中的临床疗效观察[J].,2023,(16):3143-3148 |
| 独圣活血片联合微创单一手术入路在股骨头坏死治疗中的临床疗效观察 |
| Clinical Effect in the Treatment of Femoral Head Necrosis with Dusheng Huoxue Tablet Combined with Single Approach Minimally Invasive Procedure |
| 投稿时间：2023-01-23 修订日期：2023-02-20 |
| DOI：10.13241/j.cnki.pmb.2023.16.028 |
| 中文关键词: 独圣活血片 微创入路 股骨头坏死 临床疗效 骨代谢指标 |
| 英文关键词: Dusheng Huoxue Tablet Minimally Invasive Procedure Osteonecrosis of the Femoral Head Clinical efficacy Bone metabolism indexes |
| 基金项目:四川省医学会骨科创伤专项基金项目（2019HR14） |
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| 中文摘要: |
| 摘要 目的：探讨独圣活血片联合微创单一手术入路在股骨头坏死治疗中的临床疗效观察，为治疗该病症提供方法。方法：选取2016年1月-2018年6月我院收治的98例ARCOⅡA-ⅢB分期股骨头坏死的患者作为研究对象，依据治疗方式分为A组（传统入路治疗组）、B组（微创单一入路治疗组）和C组（单一入路+独圣活血片组）。比较三组患者的临床疗效，术中和术后相关的临床指标，术后炎症指标、红细胞沉降率和骨代谢指标，NRS 疼痛评分及治疗期间的不良反应，术后1月、6月、12月的Harris 髋关节功能评分、生活质量量表及36 项健康调查简表评分（SF-36），肝肾功能、凝血功能指标及术后并发症发生情况。结果：C组治疗有效率为91.84%，明显高于A组治疗有效率70.00%和B组治疗有效率71.88%，差异有统计学意义（P＜0.05）；B组患者的卧床时间少于A组患者，C组患者的术区血肿吸收时间少于A组和B组患者，差异有统计学意义（P＜0.05）；三组术后不同时间段Harris 和SF-36评分比较有差异，随着时间推移，Harris 和SF-36评分逐渐降低差异有统计学意义（P＜0.05）；三组术后不同时间段NRS评分比较有差异，随着时间推移，NRS评分逐渐降低差异有统计学意义（P＜0.05）；三组术后不同时间段CRP、TNF-α、红细胞沉降率、CTX、TRACP-5b，比较有差异，随着时间推移，CRP、TNF-α、红细胞沉降率、CTX、TRACP-5b均逐渐降，低差异有统计学意义（P＜0.05）；C组患者的CRP、TNF-α、红细胞沉降率、CTX、TRACP-5b均明显低于A组患者和B组患者，差异有统计学意义（P＜0.05）。三组患者术后不同时间段肝肾功明、凝血功能及术后并发症发生率差异均无统计学意义（P＜0.05）。结论：独圣活血片联合微创单一入路法治疗早中期股骨头坏死具有较好的疗效和安全性，创伤小，恢复快，有助于缓解患者疼痛，促进术后血肿吸收，改善髋结节功能，帮助患者提早恢复日常生活，具有一定临床应用价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical efficacy of the treatment of femoral head necrosis with the combination of Dushenghuoxue tablets and single approach. Methods: The 98 patients with ARCOIIA-IIIB staging of femoral head necrosis from January 2016 to June 2018 were selected as subjects. According to the treatment, they were divided into group A (Traditional approach treatment group), group B (Minimally invasive single approach treatment group) and group C (Single approach + Dushengshengxue group). Compare the clinical efficacy, intraoperative and postoperative clinical indicators, postoperative inflammation index, erythrocyte sedimentation rate and bone metabolism index, NRS pain score and adverse reactions during treatment. The Harris hip function score, quality of life scale, 36 health survey short form score (SF-36), liver and kidney function, coagulation function indicators and postoperative complications at 1 month, 6 months and 12 months after surgery. Results: The effective rate of treatment in group C was 91.84%, which was significantly higher than the effective rate of 70.00% in group A and 71.88% in group B, and the differences were statistically significant (P<0.05); the group B patients had less bed rest time than group A patients, the hematoma absorption time of the patients in group C was less than that in group A and group B, and the differences were statistically significant (P<0.05); there were significant differences in Harris and SF-36 scores among the three groups at different time points after surgery, and Harris and SF-36 scores decreased gradually with time went by (P<0.05); the NRS scores of the three groups were different at different time points after surgery, as time went by, the NRS scores gradually decreased, and the differences were statistically significant(P<0.05); there were significant differences in CRP, TNF-α, erythrocyte sedimentation rate, CTX and TRACP-5B among the three groups at different postoperative time, as time went by, CRP, TNF-α, erythrocyte sedimentation rate, CTX and TRACP-5B all decreased gradually, and the low differences were statistically significant(P<0.05); CRP, TNF-α, erythrocyte sedimentation rate, CTX and TRACP-5B in group C were significantly lower than those in group A and group B, the differences were statistically significant (P<0.05). There was no significant difference in liver and kidney function, coagulation function and postoperative complication rate among the three groups at different time points after operation(P>0.05). Conclusion: Single Shenghuo Xuexue combined with single approach minimally invasive treatment for early and mid-stage femoral head necrosis has good efficacy and safety, small trauma and quick recovery, which can help relieve pain, promote postoperative hematoma absorption and improve hip nodule function. To help patients recover their daily lives early. |
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