股骨粗隆间骨折患者行闭合复位防旋股骨近端髓内钉内固定术后应用骨肽注射液对骨代谢及骨密度的影响分析

Effect of ossotide injection on bone metabolism and bone mineral density after internal fixation of closed reduction and proximal femoral anti rotation intramedullary nail in patients with femoral intertrochanteric fracture

目的 研究股骨粗隆间骨折患者行闭合复位防旋股骨近端髓内钉（PFNA）内固定术后应用骨肽注射液对骨代谢及骨密度的影响.方法 将股骨粗隆间骨折患者90例根据随机数字表法分为两组,每组45例,对照组单纯行闭合复位PFNA内固定术治疗;观察组在行闭合复位PFNA内固定术后应用骨肽注射液.对两组患者股骨粗隆间骨折平均愈合时间、术后住院时间和骨折恢复优良率进行比较,并比较两组治疗前后的血清骨钙素水平、血清碱性磷酸酶水平、骨密度、血钙和血磷水平.结果 观察组股骨粗隆间骨折平均愈合时间、术后住院时间均明显短于对照组,差异均有统计学意义（t=5.924、8.824,均P〈0.05）.观察组骨折恢复优良率明显高于对照组,差异有统计学意义（χ2=5.075,P〈0.05）.治疗前,两组血清骨钙素水平、血清碱性磷酸酶水平、骨密度、血钙和血磷水平差异无统计学意义,治疗后观察组血清骨钙素水平、血清碱性磷酸酶水平、骨密度、血钙和血磷水平分别为（5.69±0.56）μg/L、（92.52±10.59）IU/L、（0.88±0.48）g/cm2、（2.89±0.87）mmol/L、（1.93±0.59）mmol/L,均显著优于对照组,差异均有统计学意义（t=5.423、5.413、4.633、5.883、5.734,均P〈0.05）.结论 股骨粗隆间骨折患者行闭合复位PFNA内固定术后应用骨肽注射液对骨代谢及骨密度的影响显著,可有效改善骨代谢,提高骨密度,加速骨折愈合,缩短住院时间,值得推广.

Objective To study the effect of ossotide injection on bone metabolism and bone mineral density after internal fixation of closed reduction and proximal femoral anti rotation intramedullary nail in patients with femoral intertrochanteric fracture（ PFNA） . Methods 90 patients with PFNA were randomly divided into two groups according to the digital table, each group in 45 cases. The control group underwent internal fixation of closed reduction and proximal femoral anti rotation intramedullary nail for PFNA. The observation group was given ossotide injection after internal fixation of closed reduction and proximal femoral anti rotation intramedullary nail for PFNA. The healing time, postoperative hospitalization time and recovery rate were compared, and the serum osteocalcin level, serum alkaline phosphatase level,bone density,serum calcium and phosphorus levels were compared between the two groups before and after treatment. Results The average healing time and postoperative hospital stay of the observation group were significantly shorter than those of the control group （t =5. 924,8. 824,all P〈0. 05）. The recovery rate of the observation group was significantly higher than that of the control group（χ2 =5. 075,P〈0. 05）. Before treatment, there were no significant differences between the two groups in serum osteocalcin level, serum alkaline phosphatase level,bone mineral density,serum calcium and phosphorus levels. After treatment,the serum osteocalcin level,serum alkaline phosphatase level, bone mineral density, serum calcium and phosphorus levels in the observation group respectively（5.69±0.56）μg/L,（92.52±10.59）IU/L,（0.88±0.48）g/cm2,（2.89±0.87）mmol/L,（1.93± 0. 59）mmol/L,significantly better than those in the control group（t=5. 423,5. 413,4. 633,5. 883,5. 734,all P〈0. 05）. Conclusion Femoral intertrochanteric fracture patients underwent closed reduction and internal fixation with PFNA application of ossotide injection can effectively improve the bone metabolism,increase bone density,accelerate fracture healing,shorten the hospitalization time,postoperative effect,it is worthy of promotion.