两种术式治疗高龄股骨粗隆间骨折的疗效比较

Effect Comparison of Two Surgical Treatments for Advanced Age With Intertrochanteric Fracture of Femur

目的比较股骨近端防旋髓内钉(PFNA)内固定与人工股骨头置换术治疗高龄股骨粗隆间骨折的临床疗效。方法选取我院骨科2014年8月—2017年3月收治的高龄股骨粗隆间骨折患者68例为研究对象,根据患者入院编号随机分为研究组及对照组(n=34例),其中研究组给予PFNA内固定治疗,对照组给予人工股骨头置换术治疗,就两组患者手术及恢复情况进行评定比较,并就总体疗效进行分析。结果研究组患者术中出血量、住院时间、围术期并发症发生率少于对照组(P<0.05),术后两组患者改良Harris评分均随着术后时间延长不断升高,术后3个月内,研究组评分低于对照组(P<0.05),术后6个月两组评分差异无统计学意义(P>0.05)。结论在高龄股骨粗隆间骨折患者的手术术式比较研究中发现,PFNA内固定患者术中出血量较少且围术期并发症发生率较低,恢复期较短,临床可根据患者实际情况进行手术方式的选择。

Objective To compare the clinical effect of PFNA internal fixation and artificial femoral head replacement in treatment of advanced age with intertrochanteric fracture of femur.Methods 68 cases of patients with advanced age with intertrochanteric fracture of femur and who treated in our hospital from August 2014 to March 2017 were selected as the research objects,and the patients were randomly divided into the study group and the control group according to admission number(n=34 cases).The study group were given PFNA internal fixation,while the control group was treated with artificial femoral head replacement.Then,the operation and recovery of two groups of patients were compared,and the overall clinical effect were analyzed.Results The bleeding volume during the operation,the hospitalization time,complication rate of perioperative period in the study group was significantly less than those in the control group(P<0.05).The improved Harris score of two groups of patients after operation were increased with the prolongation of postoperative time.Within 3 months after operation,the score in the study group was significantly lower than that in the control group(P<0.05).There was no significant difference in scores after the operation for 6 months between the two groups(P>0.05).Conclusion The comparative study of surgical procedures in patients with intertrochanteric fracture of femur found that the bleeding during the operation in patients with PFNA internal fixation are less,the rate of complication in the perioperative period is low,and the recovery period is shorter,thus the operation mode can be chosen according to the actual situation of the patients.