PFNA和Gamma钉治疗老龄患者不稳定股骨近端骨折的疗效比较

PFNA and Gamma Nail in Treatment of Elderly Patients Compare the Efficacy of Unstable Proximal Femoral Fractures

目的探讨PFNA和Gamma钉治疗老龄患者不稳定股骨近端骨折的疗效。方法方便选取2012年4月—2015年5月该院收治不稳定股骨近端骨折老年患者70例为研究对象,随机分为PFNA组和Gamma钉组各35例,统计对比两组患者的治疗效果。结果 PFNA组患者术中出血量为（186.5±23.4）m L,手术时间为（64.6±5.2）min,Gamma钉组患者术中出血量为（194.2±24.9）m L,手术时间为（66.9±6.4）min,PFNA组患者术中出血量、手术时间与Gamma钉组相比无明显差异,t=1.333、1.650,P〉0.05。PFNA组患者术后3个月行走功能优良率77.1%与Gamma钉组51.4%相比明显较高,χ-2=5.040,P〈0.05。PFNA组患者术后6个月、1年行走功能优良率85.7%、94.3%与Gamma钉组80.0%、88.6%相比差异无统计学意义,χ-2=0.402、0.729,P〉0.05。PFNA组患者术后3个月、6个月、1年行走和休息时疼痛发生率68.6%、37.1%、0.0%与Gamma钉组74.3%、45.7%、5.7%患者相比差异无统计学意义,χ-2=0.280、0.530、2.059,P〉0.05。PFNA组患者术后6个月骨折愈合率91.4%与Gamma钉组85.7%患者相比差异无统计学意义,χ-2=0.565,P〉0.05。PFNA组患者术后1年内并发症发生率2.9%与Gamma钉组患者20.0%相比明显较低,χ-2=5.081,P〈0.05。结论PFNA治疗老龄患者不稳定股骨近端骨折与Gamma钉相比效果更佳,更助于患者术后恢复。

Objective To investigate the PFNA and Gamma nail in treatment of elderly patients unstable proximal femoral fractures. Methods Convenient selection April 2012 to May 2015 in our hospital unstable proximal femoral fractures in elderly patients with 70 cases for the study were randomly divided into groups and the Gamma nail PFNA 35 patients in each group, statistical treatment compared two groups of patients. Results PFNA group blood loss patients（186.5 ± 23.4） m L,operation time was（64.6 ± 5.2） min, blood loss in patients with Gamma nail group（194.2 ± 24.9） m L, operation time was（66.9 ± 6.4） min, bleeding volume PFNA group, operative time compared with the Gamma nail group had no significant difference, t = 1.333,1.650, P〈0.05. PFNA group of patients 3 months walking function excellent rate of 77.1% compared with51.4% Gamma nail group was significantly higher, χ-2= 5.040, P〈0.05. Postoperative PFNA group 6 months, 1 year walking function excellent rate of 85.7%, 94.3% and 80.0% Gamma nail group, no significant difference compared to 88.6%, χ-2=0.402,0.729, P〈0.05. PFNA group of patients 3 months, 6 months, 1 year walking and pain at rest incidence of 68.6%,37.1%, 0.0% and 74.3% Gamma nail group, no significant difference compared to 45.7%, 5.7% of patients, χ-2= 0.280,0.530,2.059, P〈0.05. PFNA group of patients 6 months of fracture healing rate of 91.4% compared with the Gamma nail group85.7% of patients had no significant difference, χ-2= 0.565, P〈0.05. PFNA group postoperative complication rate of 2.9% a year and Gamma nail group were significantly lower compared to 20.0%, χ-2= 5.081, P〈0.05. Conclusion PFNA treatment of elderly patients unstable proximal femoral fractures compared with Gamma nail better, more help postoperative recovery.