唑来膦酸治疗高龄骨质疏松性不稳定转子间骨折临床效果观察

The effect of zoledronic acid in the treatment of unstable and osteoporotic intertrochanteric fractures in elderly

目的探究唑来膦酸治疗高龄骨质疏松性不稳定转子间骨折的临床效果。方法收集2010年4月~2014年11月治疗的高龄骨质疏松性不稳定转子间骨折患者220例,根据抗骨质疏松药物的不同分为唑来膦酸组(观察组)和降钙素组(对照组),每组各110例,记录两组患者住院时间、骨折愈合时间、髋关节功能评分(Harris评分)、髋关节功能优良率、疼痛视觉模拟评分(VAS评分)、术后并发症及术后椎体和髋部骨密度等。结果两组患者均获得1年以上随访,两组患者平均住院时间、骨折愈合时间、Harris评分、VAS评分、术后优良率、并发症发生率差异均无统计学意义(P>0.05)。观察组术后1年腰椎骨密度和髋部骨密度分别为(0.81±0.05)g/cm2、(0.79±0.06)g/cm2,对照组分别为(0.77±0.07)g/cm2、(0.74±0.07)g/cm2,观察组均高于对照组(P<0.05)。结论唑来膦酸注射治疗高龄骨质疏松性不稳定转子间骨折疗效较好,能有效提高患者骨密度,同时并未影响骨折的愈合及髋关节的恢复,值得临床推广。

Objective To explore the effect of zoledronie acid in the treatment of unstable and osteoporotie intertroehanteric fractures in elderly. Methods Two hundred and twenty elderly patients of unstable and osteoporotic intertroehanteric fracture were collected from Apr. 2010 to Nov. 2014 in our hospital. They were randomly divided into two groups depending on the antisteoporosis drugs： the zoledronic acid group （the observation group,n = 110 ） and the calcitonin group （ the control group, n = 110 ）. The hospitalization time, the fracture healing time, hip function outcome （ Harris score ） , excellent and good rate, the VAS score, the postoperative complications and bone mineral density （BMD） of lumbar and hip were recorded and evaluated. Results Patients of the two groups obtained more than 1 year follow-up. For the hospitalization time, the fracture healing time, hip function outcome （ Harris score ） , excellent and good rate, the VAS score, the postoperative complications, the differences had no statistical significance between two groups （ P 〉 0. 05 ）. BMD of lumbar and hip in the observation group were （ 0. 81 ± 0.05 ） g/cm^2 and （ 0.79 ± 0. 06 ）g/cm2 respecuvely. And BMD of lumbar and hip in the control group were （0. 77 ± 0. 07）g/cm2 and（0. 74± 0.07） g/cm2 respectively. BMD of lumbar and hip in the observation group were higher than those in the control group （ P 〈 0. 05）. Conclusion Zoledronic acid has superior effect in unstable and osteoporotic intertrochanteric fractures. It can improve BMD but does not affect the recovery of the fracture healing and hip function and it is deserved to be promoted.