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Objective:To investigate the risk factors of lower extremity venous thrombosis in elderly patients with femoral neck fracture during perioperative period after artificial bipolar femoral head replacement and the effect of Mailuoshutong in clinical prevention and treatment of thrombosis.Methods:A retrospective case-control study was conducted on the clinical data of 92 elderly patients with femoral neck fracture who were admitted to the Affiliated Hospital of North China University of Technology from January 2015 to January 2020.According to the treatment method, the patients were divided into an observation group (44 cases) and a control group (48 cases). Patients in the observation group were treated with the combination of Mailuoshutong Pill and low molecular weight heparin calcium.The control group was treated with low molecular weight heparin calcium.The patients in both groups started anti-coagulation therapy immediately after admission, and they stopped the drug one day before operation and continued to take the drug on the second day after operation.Venous ultrasound of both lower limbs was recorded at the time of admission, on the 7th day after admission, and 14 days after surgery.The changes in hemoglobin, red blood cell count and drainage volume before and after operation were recorded.Results:The incidence of thrombosis was 2 cases (4.54%) on the 7th day after admission in the observation group and 9 cases (18.75%) in the control group.The difference was statistically significant (χ 2=4.400, P=0.036). The incidence of thrombosis was 3 cases (6.82%) in the observation group and 11 cases (22.92%) in the control group 14 days after operation.The difference was statistically significant(χ 2=4.611, P=0.032). The hemoglobin changes of observation group and control group were (23.73±6.89) g/L and (22.10±5.18) g/L respectively on the first day before operation and 48 hours after operation.The red blood cell count changes were (0.67±0.32) × 1012/L and (0.56±0.36) × 1012/L respectively, and the drainage volume of drainage tube after operation was (100.27±23.73) ml and (102.40±20.90) ml, respectively.There was no significant difference in the above indexes between the two groups (all P>0.05). Multivariate Logistic regression analysis showed that only low molecular weight heparin calcium was used to prevent and treat thrombosis ( OR=10.281, 95% CI: 1.609-65.689, P=0.014); the elderly patients ( OR=1.190, 95% CI: 1.061-1.336, P=0.003) and the thrombosis at the time of admission ( OR=8.346, 95% CI: 1.773-39.281, P=0.007) were the risk factors for lower extremity venous thrombosis on the 14th day after surgery. Conclusion:Mailuoshutong pill combined with low molecular weight heparin calcium can safely and effectively treat lower extremity venous thrombosis in perioperative period of artificial femoral head replacement for femoral neck fracture in elderly patients.Mailuoshutong pill combined with low molecular weight heparin calcium was a protective factor for lower extremity venous thrombosis 14 d after operation, while advanced age and thrombosis at the time of admission were risk factors.
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Objective:To study the clinical effect of Maizhiling tablets combined with salmon calcitonin in the treatment of elderly femoral neck fracture after artificial femoral head replacement and the influencing factors of hip joint function 6 months after operation.Methods:Prospective research methods were used in this article.A total of 84 elderly patients with femoral neck fracture who underwent artificial femoral head replacement in the Affiliated Hospital of North China University of Science and Technology from January 2017 to June 2019 were selected and randomly divided into the treatment group (41 cases) and the control group (43 cases) by the random number table method.The treatment group was treated with Maizhiling tablet and salmon calcitonin nasal spray plus basic calcium; the control group was treated with basic calcium.Independent sample t test was used to compare the visual analogue score (VAS) on the 5th day after operation, the time of complete disappearance of congestion in thigh, and the time of first ambulation after operation between the two groups.The bone mineral density (BMD) of contralateral femoral neck and Harris score of hip joint function were compared between the two groups at 14 days, 3 months and 6 months after operation by repeated measurement variance analysis.Multivariate Logistic regression was used to analyze the influencing factors of hip joint function at 6 months after operation.Results:VAS score on the 5th day after surgery: (6.34±1.54) points in the treatment group and (7.02±1.50) points in the control group.Complete regression time of thigh congestion: (12.12±2.27) d in the treatment group and (13.88±2.58) d in the control group.The first postoperative activity time was (5.93±1.52) d in the treatment group and (7.84±1.05) d in the control group, and the differences of the above indexes between the two groups were statistically significant ( t value was 2.051, 3.313, 6.673, respectively, all P<0.05). The BMD values of the contralateral femoral neck in the treatment group were (0.543±0.123), (0.561±0.119), (0.606±0.105) g/cm 2 at 14 days, 3 months and 6 months after operation, and (0.530±0.092), (0.517±0.089), (0.526±0.090) g/cm 2 in the control group.The results of variance analysis of repeated measurements showed that Fintra-group=55.726, P<0.01; Finter-group=4.206, P<0.05; Finteraction=57.654, P<0.01.There were significant differences between 3 months, 6 months and 14 days after operation in the treatment group (all P<0.01), and between 3 months and 6 months after operation ( P<0.01). In the control group, there was significant difference between 14 days and 3 months ( P<0.01), and between 3 months and 6 months ( P<0.01); 6 months after operation, the difference was statistically significant ( P<0.01). The Harris scores of hip joint in the treatment group were (82.12±8.18), (85.49±6.61), (87.10±6.57) points and (78.91±5.75), (81.44±6.42), (83.67±6.97) points in the control group.The results of repeated measurement ANOVA showed that Fintra-group=64.526, P<0.01; Finter-group=6.529, P<0.05; Finteraction=0.501, P>0.05.There were significant differences between 3 months, 6 months and 14 days after operation (all P<0.01). There were significant differences between 3 months and 6 months after operation ( P<0.05). There were significant differences between the groups 14 days, 3 months and 6 months after operation ( P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age( OR=1.318, 95% CI1.002-1.732, P=0.048) and treatment method ( OR=29.168, 95% CI 1.030-824.623, P=0.048) were risk factors for hip function on the replacement side, and Harris score of hip function 14 days after surgery ( OR=0.624, 95% CI 0.447-0.873, P=0.006) were protective factors for hip function 6 months after surgery. Conclusion:Maizhiling tablets and salmon calcitonin nasal spray have good effects on removing blood stasis, relieving pain, effectively improving bone mineral density and promoting the recovery of joint function after artificial femoral head replacement for senile femoral neck fracture.The younger age of patients, postoperative treatment with Maizhiling tablets combined with salmon calcitonin and good recovery of hip function in 14 days after operation are the protective factors of good hip function in 6 months after operation.
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Objective To observe the curative effect of Xianlinggubao capsules combined with mecobalamin tablets,manipulation and cervical traction in treatment of cervicalspondylotic radiculopathy(CSR).Methods Forty-eight cases CSR patients who were treated in Affiliated Hospital of North China University of Science and Technology from February 2013 to May 2015 were randomly divided into treatment group and control group,each group with 24 cases.All patients were treated with manipulation,cervical traction and mecobalamin tablets(0.5 mg,3 times/d),treatment group received Xianlinggubao capsule(1.5 g,2 times/d)for 21 d.Nervous pain was valued with short-form of McGill questionnaire(SF-MPQ),the difference between the two groups before and after treatment was compared with that before treatment,the pain rating index(PRI),the fuzzy pain rating scale(VAS)and the current degree of pain(PPI).Table 20 quantitative analysis of symptoms of cervical spondylosis of nerve root type was applied to assess the comprehensive evaluation of symptoms and signs,the curative effect was calculate(before and after treatment,and the ratio of the integral before treatment)of the omnibus symptoms and signs.The curative ratio and the healing time were calculated.Results The treatment group McGill in PRI,VAS and PPI score difference were significantly higher than the control group((6.16±1.94)points vs(4.87±2.12)points,(5.23±2.22)points vs.(3.63±1.74)points,(2.76±0.87)points vs.(1.26±1.01)points),the differences were statistically significant(P=0.02,0.03,0.04).Table 20 quantitative analysis index of treatment was significant higher than control group(0.72±0.15 vs.0.37±0.07),the differences were statistically significant(t=1.31,P＜0.05).The curative ratio of treatment group was much higher in control group(70.83％(17/24)vs.45.83％(11/24)),the differences were statistically significant(x2=8.15,P=0.02).The treatment group gained shorter healing time((8.31±3.11)d vs.(11.24±4.52)d,t=3.36,P=0.01).Conclusion Assured curative effect was found in Xianlinggubao capsules combined with mecobalamin tablets,manipulation and cervical traction for cervicalspondylotic radiculopathy.
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Objective To investigate the effect of the locking plate fixation with anti-osteoporosis drug in the treatment of older patients with proximal humeral fractures. Methods Sixty-two patients with proximal humeral fractures who were treated in Yuzhou Mining Company Hospital of Kailuan Group of Hebei Province from Feb. 2011 to Oct. 2013 were divided into observation group(n=30)and control group(n=32). Patients in both groups were given locking plate fixation,and patients in the observer group were also received anti-osteoporosis treatment. The information including hospitalization periods,efficacy and bone mineral density of the two groups was recorded. Results The hospitalization periods of the observation group and control group were (6. 9 ± 1. 0)d,(9. 5 ± 1. 1)d,and the difference was statistically significant(t=8. 426,P﹤0. 05). The efficacy in observer group was excellent in 17 cases,good in 10 cases,fair in 2 cases and poor in 1 case,and the efficacy of the control group was excellent in 14 cases,good in 10 cases,fair in 5 cases and poor in 3 cases. The difference was statistically significant(χ2 =4. 617,P ﹤0. 05 ). After the anti-osteoporosis treatment,the bone mineral density of the observer group and control group were( 0. 79 ± 0. 13)g/cm2 and(0. 66 ± 0. 05)g/cm, the difference was statistically significant( t =10. 251,P ﹤0. 05 ). Conclusion The effect of locking plate fixation with anti-osteoporosis drug is better with shorter hospital stay,safe and reliable,and it is worthy of clinical application.
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Objective To investigate the clinical effect of small incision for total hip arthroplasty on osteoporosis treatment of elder patients with fracture of the femoral neck.Methods Fifty-six elder patients with femoral neck methods were selected as our subjects,who were hospitalize from Jan.2011 to Dec.2013 in Xiahuayuan Meikuang Hospital,Zhangjiakou Company Limited.They were randomly divided into the observation group (26 cases) and control group (30 cases).All patients were treated with small incision total hip arthroplasty.The patients in the observation group were given the alendronate sodium.The curative effect,hospitalization time,bone mineral density were recorded.Results The long-term efficacy of the excellent and good rate of the observation group was 96.2％ (25/26),higher than that in control group(86.6％ (26/30)),and the difference was statistically significant(x2 =4.125,P ＜ 0.05).The length of hospitalized time in observation group was (26 ± 4) d,shorter than that in the control group (35 ± 3) d,and the difference was statistically significant(t =9.102,P ＜ 0.05).The bone density of patients in the observation group was (0.64 ± 0.03) g/cm2,higher than that in control((0.61 ± 0.05) g/cm2),and there was significant difference between two groups (t =8.461,P ＜ 0.05).Conclusion The effect of small incision total hip arthroplasty combined with anti osteoporosis drugs for the treatment of femoral neck fractures in the elderly is good and worthy of clinical usage.