PFNA内固定与人工全髋关节置换术治疗老年股骨粗隆间骨折的效果比较

Comparision of PFNA internal fixation and total hip arthroplasty in the treatment of senile intertrochanteric femoral fractures

目的对比分析防旋股骨近端髓内钉(PFNA)内固定与人工全髋关节置换术(THA)应用于老年股骨粗隆间骨折的效果。方法采用随机数字表法将80例老年股骨粗隆间骨折患者分为对照组与观察组,各40例。观察组接受PFNA内固定术,对照组接受THA。对比两组围术期情况、入院时、术后1、3个月Harris评分及术后并发症发生情况。结果观察组患者术中失血量、术后引流量少于对照组,手术时间短于对照组,但术后卧床时间长于对照组(P<0.05)。术后1、3个月,两组患者的Harris评分均升高,且观察组高于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论与THA比较,PFNA内固定的实施能够有效缩短老年股骨粗隆间骨折患者手术时间,减少出血量,手术安全性更高。

Objective To compare the effect of proximal femoral nail anti-rotation(PFNA)internal fixation and total hip arthroplasty(THA)in the treatment of senile intertrochanteric femoral fractures.Methods Eighty cases of senile intertrochanteric femoral fractures patients were divided into control group and observation group by random number table method,with 40 cases in each group.The observation group received PFNA internal fixation,while the control group received THA.The perioperative conditions,Harris scores at admission,postoperative 1 and 3-month and postoperative complications were compared in the two groups.Results The intraoperative bleeding volume and postoperative drainage volume in the observation group were less than those in the control group,the operation time of the observation group was shorter than that of the control group,but the postoperative bed rest time of the observation group was longer than that of the control group(P<0.05).At postoperative 1,3-month,the Harris scores in the two groups increased,and those in the observation group were higher than the control group(P<0.05).The total incidence of complications in the observation group was lower than that of the control group(P<0.05).Conclusion Compared with THA,PFNAinternal fixation in the treatment of senile intertrochanteric femoral fractures can shorten operation time and reduce bleeding volume,with higher safety.