鲑鱼降钙素鼻喷剂治疗老年股骨粗隆间骨折的临床研究

Clinical trial of salmon calcitonin nasal spray in the treatment of elderly patients with intertrochanteric fracture of femur

目的观察鲑鱼降钙素鼻喷剂治疗老年股骨粗隆间骨折的临床疗效及安全性。方法将60例患者随机分为对照组和试验组,每组30例。对照组予以近端防旋髓内钉治疗;试验组在对照组治疗的基础上,术后予以鲑鱼降钙素鼻喷剂每次20μg,qod,治疗8~12个月。比较2组患者的临床疗效、骨密度、髋关节-Harris评价,以及药物不良反应的发生情况。结果术后,试验组和对照组的骨折愈合时间分别为(18.27±0.84)和(22.64±1.02)周,差异有统计学意义(P<0.05)。试验组和对照组的术后0.5年髋部健侧骨密度分别为(-1.94±0.16)和(-2.23±0.20),术后1年髋部健侧骨密度分别为(-1.62±0.17)和(-2.01±0.19),术后1年髋关节-Harris评价的优良率分别为96.67%(29例/30例)和73.33%(22例/30例),差异均有统计学意义(均P<0.05)。2组患者的并发症均以内固定切割和下肢静脉血栓为主,试验组和对照组的总并发症发生率分别为10.00%和23.33%,差异有统计学意义(P<0.05)。结论鲑鱼降钙素鼻喷剂治疗老年股骨粗隆间骨折的临床疗效确切,其能加快骨折愈合,增加骨密度,且安全性较好。

Objective To observe the clinical efficacy and safety of salmon calcitonin nasal spray in the treatment of elderly patients with intertrochanteric fracture of femur. Methods A total of 60 elderly patients with intertrochanteric fracture of femur were randomly divided into control and treatment groups with 30 cases per group. Control group was treated with proximal femoral nail anti-rotation（ PFNA）. Treatment group received salmon calcitonin nasal spray 20 μg per time,qod with 8-12 month,on the basis of control group. The clinical efficacy,bone mineral density,Harris evaluation of hip joint and complication were compared between two groups. Results After operation,fracture healing time of treatment and control groups were（ 18. 27 ± 0. 84） and（ 22. 64 ± 1. 02）weeks with significant difference（ P 0. 05）. The main indexes of treatment and control groups were compared： bone density on healthy side of hip 0. 5 year after operation were（-1. 94 ± 0. 16） and（-2. 23 ± 0. 20）,bone density on healthy side of hip 1 year after operation were（-1. 62 ± 0. 17） and（-2. 01 ± 0. 19）,excellent and good rates with Harris evaluation of hip joint were 96. 67%（ 29 cases/30 cases） and73. 33%（ 22 cases/30 cases）,the differences were statistically significant（ all P 0. 05）. The complication of two groups were internal fixation and lower extremity deep venous thrombosis. The total incidences of complication in treatment and control groups were 10. 00% and 23. 33% without significant difference（ P 0. 05）. Conclusion Salmon calcitonin nasal spray has a definitive clinical efficacy and safety in the treatment of elderly patients with intertrochanteric fracture of femur,which can accelerate fracture healing and increase bone density.