摘要
目的:探究gamma钉髓内固定和自动力内固定架髓外固定对老年患者股骨粗隆间骨折的临床疗效及健康相关生活质量的影响。方法:选择2018年7月-2020年1月本院骨科行股骨粗隆间骨折复位内固定术治疗的老年患者120例,依照随机数字表法,采用自动力内固定架行髓外固定65例患者为髓外组,采用gamma钉行髓内固定的55例患者为髓内组。比较两组患者的手术时间、住院时间、术中出血量、引流量、开始负重时间,以及术前和术后12个月两组患者生活质量评分。结果:术后12个月时,髓内组随访53例(失访2例),髓外组随访60例(失访5例)。住院时间髓外组(10.98±1.61)d,髓内组(10.41±0.97)d,(t=1.497,P>0.05);手术时间髓外组(57.55±7.86)min,髓内组(44.68±8.10)min,(t=-14.633,P<0.001);术中出血量髓外组(245.15±5.02)mL,髓内组(113.79±4.11)mL,(t=10.565,P<0.001);开始负重时间髓外组(15.85±2.29)周,髓内组(7.38±0.49)周,(t=25.289,P<0.001);引流量髓外组(95.90±7.81)mL,髓内组(60.91±5.72)mL,(t=19.512,P<0.001)。患者健康相关生活质量评价量表SF-36总分,两组相比差异无统计学意义(P>0.05),两组组内相比差异有统计学意义(P<0.05)。结论:股骨粗隆间骨折行Gamma钉更易操作,创伤较小,术后更早行负重锻炼,值得临床推广应用。但术后12个月无论是髓内固定还是髓外固定,对患者生活质量的影响差异不明显。
Objective:To explore the clinical efficacy of gamma nail intramedullary fixation and automatic force internal fixation for the treatment of femoral intertrochanteric fractures in elderly patients and their impact on health-related quality of life.Methods:A total of 120 elderly patients who came to the Department of Orthopedics of our hospital for treatment of femoral intertrochanteric fracture reduction and internal fixation from July 2018 to January 2020 were selected.65 patients were for extramedullary fixation with automatic internal fixation,and 55 patients who used gamma nails for intramedullary fixation belonged to the intramedullary group.The operation time,hospitalization time,intraoperative blood loss,drainage volume,and weight-bearing time of the two groups were compared,and the quality of life scores of the two groups were compared 1 day before and 1 year after the operation.Results:At 12 months postoperatively,53 cases were followed up in the intramedullary group(2 cases were lost to follow-up),60 cases in the extramedullary group(5 cases were lost to follow-up).The length of stay in the extramedullary group was(10.98±1.61)days,the length of stay in the intramedullary group was(10.41±0.97)days,and the difference was not statistically significant(t=1.497,P>0.05);the operation time of the extramedullary group was(57.55±7.86)minutes,the operation time of the intramedullary group was(44.68±8.10)minutes,and the difference was significant(t=-14.633,P<0.001);the intraoperative blood loss was(245.15±5.02)mL in the extramedullary group and(113.79±4.11)mL in the intramedullary group,and the difference was statistically significant(t=10.565,P<0.001);the weight-bearing time for the extramedullary group was(15.85±2.29)weeks,the intramedullary group was(7.38±0.49)weeks,and the difference was statistically significant(t=25.289,P<0.001);the volume of drainage of the extramedullary group was(95.90)±7.81mL,the intramedullary group was(60.91±5.72)mL,and the difference was statistically significant(t=19.512,P<0.001).There was no statistical difference of the health changes reflected by the total score of SF-36 in the two groups(P>0.05),and the difference within each group was significant(P<0.05).Conclusion:Compared with SIF extramedullary fixation,gamma nails are easier to operate and less traumatic to patients,with weight-bearing exercises performed earlier after surgery,which are worthy of clinical application.However,whether it is intramedullary fixation or extramedullary fixation,there is no significant difference in the quality of life of patients 1 year after surgery,and good clinical results can be achieved.
作者
廖志光
翁永前
莫世奋
LIAO Zhiguang;WENG Yongqian;MO Shifen(The Seventh People's Hospital of Nanhai District,Foshan 528247,China)
出处
《包头医学院学报》
CAS
2022年第4期40-44,共5页
Journal of Baotou Medical College
关键词
股骨粗隆间骨折
髓内固定
髓外固定
生活质量
Intertrochanteric fracture of femur
Intramedullary fixation
Extramedullary fixation
Quality of life
作者简介
通讯作者:廖志光。
