影响老年股骨粗隆间骨折患者PFNA内固定治疗效果的Logistic分析

Logistic analysis of the effect of PFNA internal fixation for elderly patients with intertrochanteric fracture of femur

目的采用Logistic分析影响老年股骨粗隆间骨折患者股骨近端防旋髓内钉(PFNA)内固定治疗效果的因素。方法将我院骨科2016年3月至2017年3月间收治的80例择期行PFNA治疗的股骨粗隆间骨折老年患者纳为研究对象,对其性别、年龄、骨折分型、ASA分级、骨质疏松、手术时机、手术时间等资料进行统计,采用Logistic回归分析影响患者治疗效果的因素。结果单因素分析发现,老年股骨粗隆间骨折患者PFNA内固定治疗效果与其年龄、骨折分型、ASA分级、骨质疏松及手术时机有关(P<0.05),与其性别及手术时间无关(P>0.05);Logistic回归分析发现,年龄≥80岁、不稳定型骨折、ASA高风险、骨质疏松均为影响老年股骨粗隆间骨折患者PFNA内固定治疗效果的危险因素(P<0.05)。结论年龄≥80岁、不稳定骨折、ASA高风险、骨折疏松均将对老年股骨粗隆间骨折患者PFNA内固定术效果造成不良影响,加强患者基础性疾病的控制、提高其免疫功能、降低手术风险,增加营养支持与骨形成作用,对患者术后康复具有积极作用。

Objective Logistic analysis was used to analyze the factors influencing the treatment effect of proximal femoral nail anti rotation（PFNA） in elderly patients with intertrochanteric fractures. Methods 80 elderly patients with intertrochanteric fracture treated by PFNA in the Department of orthopedics of our hospital were treated as the subjects. The data of sex,age,fracture classification,ASA classification,osteoporosis,operation time,operation time and so on were statistically analyzed,and the factors affecting the treatment effect were analyzed by Logistic regression analysis. Results Single factor analysis showed that PFNA internal fixation was related to age,fracture type,ASA classification,osteoporosis and operation time（P〈0. 05） in the elderly patients with intertrochanteric fractures（P〈0. 05）,not related to their sex and operation time（P〉0. 05）. Logistic regression analysis found that the age of more than 80 years old,unstable fracture,high risk of ASA,and osteoporosis all affected the intertrochanteric femoral intertrochanteric Risk factors of PFNA internal fixation for fracture patients（P〈0. 05）. Conclusion Age more than 80 years old,unstable fracture,high risk of ASA,and fracture loose will all have adverse effects on the effect of PFNA internal fixation for the elderly intertrochanteric fracture of the aged,strengthen the control of the basic diseases,improve the immune function,reduce the risk of operation,increase the nutritional support and bone formation,and have positive effect on the recovery of the patients after operation.