股骨近端防旋髓内钉治疗老年股骨转子间骨折的疗效

Effect of proximal femoral nail anti-rotation in the treatment of elderly patients with femoral intertrochanteric fractures

目的探究股骨近端防旋髓内钉(PFNA)治疗老年股骨转子间骨折的疗效。方法采用PFNA对135例老年股骨转子间骨折患者进行治疗。分析患者治疗后不同时间的VAS、Harris评分、骨代谢标志物、血清细胞因子水平。结果术后3、30 d,患者VAS评分、CTX-Ⅰ、PCT、IL-6、IL-1β及TNF-α水平均显著低于术前,Harris评分、BGP、PⅠNP及TGF-β水平均显著高于术前,差异具有统计学意义(P<0.05);术后30 d,患者VAS评分、CTX-Ⅰ、PCT、IL-6、IL-1β及TNF-α水平均显著低于术后3 d,Harris评分、BGP、PINP及TGF-β水平均显著高于术后3 d,差异具有统计学意义(P<0.05)。结论 PFNA治疗老年股骨转子间骨折疗效显著,可有效减轻患者疼痛,改善骨代谢,促进骨愈合,同时亦能够抑制机体炎症反应,值得临床推荐。

Objective To explore the effect of proximal femoral nail anti-rotation （PFNA） in the treatment of elderlypatients with femoral intertrochanteric fractures. Methods A total of 135 elderly patients with femoral intertrochantericfractures were treated with PFNA. The scores of VAS, Harris, levels of bone metabolism markers and serum cytokines atdifferent times after treatment were analyzed. Results At 3 and 30 days after operation, the VAS scores, levels of CTX-玉,PCT, IL-6, IL-1茁 and TNF-琢 were significantly lower than those before operation, the Harris scores, levels of BGP,P玉NPand TGF-茁 were significantly higher than those before operation, the differences were statistically significant（P〈0.05）. At 30days after operation, the VAS scores, levels of CTX-玉, PCT, IL-6, IL-1茁 and TNF-琢 were significantly lower than those at3 days after operation, the Harris scores, levels of BGP, PINP and TGF-茁 were significantly higher than those at 3 days afteroperation, the differences were statistically significant（P〈0.05）. Conclusion PFNA is effective in the treatment of elderlypatients with femoral intertrochanteric fractures. It can effectively alleviate pain of patients, improve bone metabolism,promote bone healing, and inhibit inflammation reaction in the body. It is worthy of clinical recommendation.