摘要
目的:探讨采用股骨近端方旋髓内钉固定术(PFNA)结合抗骨质疏松药物治疗老年股骨粗隆间骨折的临床效果。方法:选取2020年6月-2022年6月嘉峪关市中医医院骨伤科收治的老年股骨粗隆间骨折患者50例作为研究对象,利用Excel函数法分为对照组与观察组,各25例。对照组给予股骨近端方旋PFNA术治疗,观察组给予PFNA结合抗骨质疏松药物治疗。比较两组患者临床指标、骨形成与骨吸收水平、髋关节功能评分量表(髋关节Harris)评分及视觉模拟疼痛评分量表(VAS)评分、骨密度。结果:观察组住院时间、肿胀消退时间、负重行走时间、骨痂出现时间、骨折愈合时间均短于对照组,差异有统计学意义(P<0.05);观察组骨特异性碱性磷酸酶、血清骨钙素、Ⅰ型胶原羧基C端交联肽、Ⅰ型前胶原氨基端原肽、抗酒石酸酸性磷酸酶、尿吡啶酚水平均低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者髋关节Harris评分均升高,VAS评分均降低,观察组髋关节Harris评分高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者股骨大粗隆、股骨颈骨密度均升高,观察组高于对照组,差异有统计学意义(P<0.05)。结论:老年股骨粗隆间骨折采用PFNA结合抗骨质疏松药物治疗的临床效果显著,可缩短症状反应时间,降低疼痛程度,改善髋关节功能、骨形成与骨吸收水平,增加骨密度。
Objective:To investigate the clinical effect of proximal femoral nail fixation(PFNA)combined with anti-osteoporosis drugs in the treatment of intertrochanteric fracture of femur in the elderly.Methods:Fifty elderly patients with intertrochanteric fracture of femur treated in the Department of Orthopaedics,Jiayuguan Hospital of Traditional Chinese Medicine from June 2020 to June 2022 were selected as the research objects,and were divided into control group and observation group by Excel function method,with twenty-five cases in each group.The control group was treated with PFNA,and the observation group was treated with PFNA combined with anti-osteoporosis drugs.Clinical indexes,bone formation and bone resorption levels,hip joint function scale(hip Harris)score,visual analog pain scale(VAS)score,and bone density were compared between the two groups.Results:Hospitalization time,swelling regression time,weight-bearing walking time,callus occurrence time and fracture healing time in observation group were shorter than those in control group,and the difference was statistically significant(P<0.05).The levels of bone specific alkaline phosphatase,serum osteocalcin,carboxyl C-terminal cross-linked peptide of typeⅠcollagen,amino terminal propeptide of typeⅠcollagen,antitartrate acid phosphatase and uropyridinol in observation group were lower than those in control group,with statistical significance(P<0.05).After treatment,the hip Harris score was increased and the VAS score was decreased in both groups.The hip Harris score in the observation group was higher than that in the control group,while the VAS score was lower than that in the control group,with statistical significance(P<0.05).After treatment,bone density of femoral greater trochanter and femoral neck increased in both groups,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).Conclusion:In elderly patients with intertrochanteric fracture of femur,PFNA combined with anti-osteoporosis drugs has significant clinical effect,which can shorten symptom response time,reduce pain,improve hip function,bone formation and bone resorption level,and increase bone density.
作者
段旗展
苏兴平
刘永青
王冬
邱伟
Duan Qi-zhan;Su Xing-ping;Liu Yong-qing;Wang Dong;Qiu Wei(Department of Orthopaedics,Jiayuguan Hospital of Traditional Chinese Medicine,Jiayuguan 735100,Gansu Province,China)
出处
《中外医药研究》
2022年第14期33-35,共3页
JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH
