人工股骨头置换与PFNA治疗高龄不稳定型股骨粗隆间骨折的疗效对比分析

Comparative Analysis of the Effect of Artificial Femoral Head Replacement and PFNA in the Treatment of Unstable Intertrochanteric Fractures in Elderly Patients

目的:分析对比人工股骨头置换与PFNA治疗高龄不稳定型股骨粗隆间骨折的疗效。方法:选取从2012年1月至2016年1月本院收治的高龄不稳定型股骨粗隆间骨折患者60例作为研究对象,按患者所选手术方式分为两组。对照组采取PFNA内固定治疗方案;观察组采用人工股骨头置换术治疗。观察比较两组患者一般手术指标情况,并比较两组治疗后髓关节Harris评分及术后并发症发生情况。结果:观察组负重时间和住院时间明显低于对照组;但手术时间和术中出血量明显大于对照组,差异有统计学意义(P<0.05)。两组治疗后观察组并发症总发生率17.14%明显低于对照组40.00%,差异有统计学意义(P<0.05)。经治疗观察组1月、3月患者髓关节Harris评分显著高于对照组,差异有统计学意义(P<0.05);6月髓关节Harris评分略高于对照组。结论:人工股骨头置换手术能够帮助患者减少卧床时间,较早恢复行走功能和自理能力,减少并发症的发生,提高患者的生活质量。因此,对于高龄不稳定型股骨粗隆间骨折患者可采用人工股骨头置换术进行治疗。

Objective： To analyze and compare the artificial femoral head replacement and PFNA in the treatment of unstable intertrochanteric fractures in elderly patients. Methods： From January 2012 to January2016,60 elderly patients with unstable intertrochanteric fracture were selected as the research objects,and they were divided into two groups according to the selected surgical methods. The control group was treated with PFNA internal fixation,and the observation group was treated with artificial femoral head replacement.The general operation indexes of the two groups were observed and compared,and the Harris scores and postoperative complications of the two groups were compared. Results： The loading time and length of stay in the observation group were significantly lower than those in the control group; But the operation time and intraoperative blood loss were significantly greater than those in the control group,the difference was statistically significant（P 〈0.05）. After treatment,the total incidence of complications in the observation group was 17.14%,which was significantly lower than that in the control group（40%）,and the difference was statistically significant（P 〈0.05）. The difference between the two groups was statistically significant. After treatment,observation group patients with hip Harris score was significantly higher than the control group,the difference was statistically significant（P 〈 0. 05）; Harris hip score was slightly higher than that of the control group after 6 months. Conclusion： Artificial femoral head replacement surgery can help patients reduce the bed time,early recovery of walking function and self-care ability,reduce complications,improve the quality of life of patients.Therefore,the elderly patients with unstable intertrochanteric fracture can be treated with artificial femoral head replacement.