降钙素在老年股骨颈骨折双极股骨头置换术后的应用效果

Effectiveness of Application of Calcitonin in the elderly patients with femoral neck fracture after bipolar femoral head replacement

目的探讨降钙素在老年股骨颈骨折双极股骨头置换术后的应用效果。方法选取2013年1月~2015年6月我院收治的采用双极股骨头置换治疗的59例老年股骨颈骨折患者作为研究对象,随机分为降钙素组和对照组,其中降钙素组29例,对照组30例。降钙素组术后应用降钙素1年以上,对照组行股骨头置换术后未应用降钙素。观察两组患者的髋关节Harris评分、健侧髋骨密度、再骨折风险以及术后并发症等情况。结果 59例患者均随访至少2年,两组均无手术切口感染、肺栓塞、关节脱位及肺部感染等并发症,对照组术后发生1例深静脉血栓。降钙素组患者未发生再骨折情况,对照组1例术后11个月并发桡骨远端骨折。降钙素组患者术后6个月、1年、2年健侧髋骨密度T值与对照组比较,差异有统计学意义(P<0.05)。降钙素组患者术后6个月、术后1年、2年Harris评分均优于对照组,差异有统计学意义(P<0.05)。结论老年股骨颈骨折行双极股骨头置换术后联合使用降钙素有利于改善患者的骨密度,可早期更好地恢复髋关节功能。

Objective To investigate the effect of calcitonin in the elderly patients with femoral neck fracture after bipolar femoral head replacement.Methods A total of 59 elderly patients with femoral neck fracture who were treated with bipolar femoral head replacement in our hospital from January 2013 to June 2015 were selected as the subjects,and randomly divided into calcitonin group and control group,with 29 cases in calcitonin group and 30 cases in control group.Calcitonin was used for more than one year after the operation,and the control group was not treated with calcitonin after the replacement of the femoral head.The Harris hip scores,the hip bone density of the healthy side,the risk of re-fracture and the postoperative complications between the two groups were observed.Results All 59 patients were fol- lowed up for at least 2 years.There were no complications such as surgical incision infection,pulmonary embolism,joint dislocation and pulmonary infection in the two groups.1 case of deep vein thrombosis occurred in the control group after operation.There was no re-fracture in the calcitonin group,and 1 case in the control group were complicated with distal radius fractures at 11 months after operation.The T value of the hip bone density in the calcitonin group at 6 months,1 year and 2 years after the operation was statistically significant compared with the control group （P〈0.05）.The Harris hip scores in the calcitonin group were better than those in the control group at 6 months,1 year and 2 years after operation,the differences were statistically significant （P〈0.05）.Conclusion The combined use of calcitonin in elderly pa- tients with femoral neck fracture after bipolar femoral head replacement is beneficial to improve bone mineral density and early recovery of hip joint function.