股骨近端防旋髓内钉治疗老年股骨粗隆间骨折隐性失血的影响因素分析

Analysis of the influencing factors of proximal femoral anti-rotation intramedullary nail in the treatment of intertrochanteric fracture in senile patients with recessive blood loss

目的研究分析股骨近端防旋髓内钉(PFNA)治疗老年股骨粗隆间骨折(FIF)隐性失血的影响因素。方法回顾性分析2013年8月~2018年2月就诊于广东省深圳市龙岗区人民医院的80例老年FIF患者,所有患者均给予PFNA术式治疗,统计并记录患者的资料数据,随访6个月,分析患者的疗效情况,PFNA治疗FIF隐性失血的单因素及影响因素。结果 80例患者经过PFNA治疗后,总有效率为98.75%。年龄≥70岁、有基础疾病以及不稳定性骨折患者的隐性失血量均分别较年龄<70岁、无基础疾病及稳定性骨折者更高(P <0.05)。Logistic回归分析发现,PFNA治疗FIF隐性失血的影响因素包括年龄≥70岁、有基础疾病,以及不稳定性骨折(P <0.01)。结论应用PFNA治疗老年FIF患者的效果较好,导致其发生隐性失血的影响因素主要有年龄≥70岁、有基础疾病,以及不稳定性骨折,临床上可对上述因素采取干预措施以帮助患者获得更好的预后。

Objective To investigate and analyze the influencing factors of proximal femoral anti-rotation intramedullary nail(PFNA)in the treatment of senile intertrochanteric fracture(FIF).Methods Retrospective analysis was performed on 80 elderly FIF patients admitted to Shenzhen Longgang District People′s Hospital from August 2013 to February 2018,All patients were given PFNA operative treatment,and data of the patients were statistically recorded.The patients were followed up for 6 months to analyze the efficacy of the patients and the single and influential factors of PFNA in the treatment of FIF occult blood loss.Results After PFNA treatment,the total effective rate of 80 patients was 98.75%.Recessive blood loss was higher in patients aged≥70 years,with basic diseases and unstable fractures than in patients aged<70 years,without basic diseases and stable fractures,respectively(P<0.05).According to the Logistic regression analysis,the influencing factors of PFNA in the treatment of FIF occult blood loss include age≥70 years old,basic diseases,and unstable fractures(P<0.01).Conclusion The therapeutic effect of PFNA on the treatment of elderly FIF patients is relatively good,and the main influencing factors for the occurrence of recessive blood loss are age≥70 years old,underlying diseases,and unstable fractures.Clinically,intervention measures can be taken for the above factors to help patients obtain a better prognosis.