降钙素联合阿法骨化醇治疗老年骨质疏松性桡骨远端骨折的临床疗效观察

Clinical Curative Effect of Calcitonin combined with Alfacalcidol in the treatment of Osteoporotic Distal Radius Fractures in the Elderly

目的:观察降钙素联合阿法骨化醇治疗老年骨质疏松性桡骨远端骨折的临床疗效。方法:选择本院2015年3月至2017年6月收治的老年骨质疏松性桡骨远端骨折患者90例,随机数字表格法分为治疗组与对照组,各45例。均接受切开复位内固定治疗,治疗组术后给予鲑鱼降钙素50U/次注射+0.25μg/次、2次/d阿法骨化醇口服,对照组仅给予阿法骨化醇口服。均治疗3个月。对比两组治疗前后视觉模拟评分(VAS)、骨密度测定,统计住院时间、骨折愈合时间、腕关节功能恢复优良率及不良反应。结果:两组治疗后VAS评分比治疗前均显著下降,腰椎L2~4、股骨颈骨密度均显著提高,差异有统计学意义(P<0.05);治疗组治疗后VAS评分显著低于对照组,腰椎L2~4、股骨颈骨密度均显著高于对照组,住院时间及骨折愈合时间均显著短于对照组,差异有统计学意义(P<0.05);治疗组腕关节功能恢复优良率91.11%,显著高于对照组的73.33%(P<0.05);两组药物不良反应发生率比较差异无统计学意义(P>0.05)。结论:降钙素联合阿法骨化醇治疗老年骨质疏松性桡骨远端骨折安全有效。

Objective： To observe the clinical curative effect of calcitonin combined with alfacalcidol in the treatment of osteoporotic distal radius fractures in the elderly. Methods： 90 elderly patients with osteoporotic distal radius fractures who were admitted to the hospital from March 2015 to June 2017 were selected and randomly divided into the treatment group and the control group,45 cases in each group. All patients were treated by open reduction and internal fixation. The treatment group was treated with salmon calcitonin 50 U/times ＋0.25 μg/times and twice/d of alfacalcidol after operation,while the control group was only treated with alfacalcidol. All patients were treated for 3 months. The visual analogue scale（ VAS） scores and bone mineral density（ BMD） in the two groups were determined. The length of hospital stay,fracture healing time,excellent and good rate of wrist function recovery and adverse reactions were statistically analyzed. Results： After treatment,VAS scores of the two groups were significantly decreased while BMD of lumbar vertebra L2-4 and femoral neck were significantly increased（ P〈0. 05）. After treatment,the VAS score in the treatment group was significantly lower than that in the control group,BMD of lumbar vertebra L2-4 and femoral neck were significantly higher than those in the control group,the length of hospital stay and fracture healing time were significantly shorter than those of the control group（ P〈0.05）. The excellent and good rate of wrist function recovery in the treatment group was significantly higher than that in the control group（ 91.11% vs 73.33%）（ P〈0.05）. There was no significant difference in the incidence of adverse drug reactions between the two groups（ P〉0.05）. Conclusion： Calcitonin combined with alfacalcidol is effective and safe in the treatment of osteoporotic distal radius fractures in the elderly.