摘要
目的:观察股骨近端防旋髓内钉(PFNA)内固定术对老年股骨粗隆间骨折患者关节功能恢复的影响。方法:选取2018年1月—2022年1月九江市第一人民医院收治的老年股骨粗隆间骨折患者共68例,以随机数字表法分为观察组(34例)与对照组(34例),对照组实施半髋关节置换术治疗,观察组实施PFNA内固定术治疗。观察两组治疗效果、手术指标、疼痛程度、髋关节功能(Harris评分)及骨密度水平。结果:观察组总优良率为97.06%,优于对照组的82.36%,差异有统计学意义(P<0.05);与对照组比较,观察组术中出血量、术后引流量均更少,手术时间、住院时间均更短(P<0.05)。术后8、24、48 h,观察组视觉模拟评分法(visual analogue scale,VAS)评分均低于对照组(P<0.05)。术前,两组Harris评分、骨密度(股骨大粗隆、股骨颈及Ward三角区)水平比较,差异均无统计学意义(P>0.05);术后3个月及6个月,观察组Harris评分均高于术前与对照组(P<0.05)。术后6个月,两组股骨大粗隆、Ward三角区、股骨颈骨密度水平均高于术前,且观察组均高于对照组(P<0.05)。结论:PFNA内固定术可缩短老年股骨粗隆间骨折患者手术治疗时间,对术中出血量及术后引流量均可明显减少,减轻术后疼痛程度,并缩短住院时间,改善髋关节功能,并纠正骨量流失与骨质疏松状况,临床疗效显著,可作为临床治疗老年股骨粗隆间骨折的优选方案。
Objective:To observe the effect of proximal femoral nail anti rotation(PFNA)internal fixation on the recovery of joint function in elderly patients with intertrochanteric fracture of femur.Method:A total of 68 elderly patients with intertrochanteric fracture of femur in Jiujiang NO.1 People's Hospital from January 2018 to January 2022 were selected and divided into observation group(34 cases)and control group(34 cases)by random number table method.The control group was treated with hemiarthroplasty,while the observation group was treated with PFNA internal fixation.The therapeutic effect,surgical indexes,pain degree,hip function(Harris score)and bone mineral density of the two groups were observed.Result:The total excellent and good rate in the observation group was 97.06%,which was better than 82.36%in the control group,the difference was not statistically significant(P<0.05).Compared with the control group,the intraoperative bleeding volume and postoperative drainage volume in the observation group were less,and the operation time and hospitalization time were shorter(P<0.05).At 8,24,48 h after operation,the visual analogue scale(VAS)scores in the observation group were lower than those in the control group(P<0.05).There were no significant differences in Harris score and bone mineral density(greater trochanter,femoral neck and Ward triangle)between the two groups before operation(P>0.05).At 3 and 6 months after operation,Harris scores of the observation group were lower than those of preoperative and control group(P<0.05).Six months after operation,the bone mineral density levels of femoral trochanter,Ward triangle and femoral neck in both groups were higher than those before operation,and the observation group were higher than those in the control group(P<0.05).Conclusion:PFNA internal fixation can shorten the operation time in elderly patients with intertrochanteric fracture of femur,reduce the amount of intraoperative bleeding and postoperative drainage volume,reduce the degree of postoperative pain,shorten the hospital stay,improve hip joint function,and correct the bone loss and osteoporosis,has a significant effect in the treatment of elderly intertrochanteric fracture of femur,it can be used as the optimal scheme for clinical treatment of elderly intertrochanteric fracture of femur.
作者
杨敏捷
杨永华
胡斌
罗素梅
YANG Minjie;YANG Yonghua;HU Bin;LUO Sumei(Jiujiang NO.1 People's Hospial,Jiangxi Province,Jiujiang 332000,China;不详)
出处
《中国医学创新》
CAS
2023年第31期46-50,共5页
Medical Innovation of China
关键词
老年
股骨粗隆间骨折
PFNA内固定术
关节功能
骨密度
Elderly
Intertrochanteric fracture of femur
PFNA internal fixation
Joint function
Bone mineral density
作者简介
通信作者:罗素梅。
