经皮加压钢板固定与动力髋螺钉在治疗老年股骨转子间骨折的临床疗效比较

Curative effect of percutaneous compression plate system versus dynamic hip screw in elderly femoral intertrochanteric fractures

目的比较经皮加压钢板固定（PCCP）与动力髋螺钉（DHS）在治疗老年股骨转子间骨折的临床疗效。方法将2009年2月-2012午2月西安市中医院诊治的80例老年股骨转子间骨折患者按照随机数字表法随机分入PCCP组与DHS组，给予42例PCCP组患者PCCP，给予38例DHS组患者DHS内固定。比较两组患者出血量、视觉模拟评分法（VAS）疼痛评分、手术时间、骨折愈合情况及Hams髋功能评分。结果PCCP组术中出血量为（75．31±12．69）mL，显著少于DHS组（93．28±18．46）mL（P〈0．05）；PCCP组术后4周VAS疼痛评分为（2．09±0．27），显著低于DHS组（3．31±0．39）（P〈0．05）；PCCP组手术时间显著少于DHS组[（56．24±10．75）vs（68．54±11．47）min，P〈0．05）1；两组骨折愈合时间无显著差别[（3．98±0．87）vs（4．20±0．94）mon，P〉0．05）1：PCCP组与DHS组Harris髋功能评分优良率分别为85．7％和65．8％，差异具有显著性（P〈0．05）。结论与DHS相比，PCCP治疗老年股骨转子间骨折具有对机体损伤小、手术时间少及关节功能恢复理想的优点。

[ Objective] To compare the effect of percutaneous compression plate system （PCCP） versus dynamic hip screw （DHS） in femoral intertrochanteric fractures in elderly patients. [ Methods ] From February 2009 to February 2012, 80 patients administered in Xi＇an Traditional Chinese Medicine Hospital were randomly divided into DHS group and PCCP group according to random number table. 38 cases of DHS were given DHS treatment and 42 PCCP group received PCCP treatment. Blood loss, operation time, VAS scores, fracture healing-time and Harris score were compared between two groups. [ Results ] Blood loss in PCCP group was （75.31±12.69） mL, of which was much less than that in DHS group （93.28±18.46） mL（P 〈0.05）; On 4 weeks after operation, VAS scores in PCCP group were superior to DHS [（2.09±0.27） vs （3.31±0.39）, （P 〈0.05）]; The operation time in PCCP group was much less than that in DHS group[（56.24±10.75 vs （68.54±11.47） min, （P 〈0.05）]; There were no significant difference of fracture healingtime in two groups[（3.98±0.87） vs （4.20±0.94） rain, （P 〉0.05）]; Harris scores were 85.7% and 65.8% in PCCP group and DHS groups （P 〈0.05）. [ Conclusion ] Compared to DHS, PCCP treatment in elderly femoral intertrochanteric fi＇actures showed less injure, shorter operation time and ideal joint function recovery.