不同手术方式治疗高龄股骨粗隆间骨折的效果比较

Comparison of the Effects of Different Surgical Methods in the Treatment of Intertrochanteric Fractures in Elderly Patients

目的观察股骨近端防旋髓内钉(PFNA)和人工股骨头置换术治疗高龄股骨粗隆间骨折的效果。方法选取我院骨科2016年7月-2018年6月收治的110例高龄股骨粗隆间骨折患者作为研究对象,根据数字表法随机分为对照组55例和观察组55例。对照组采用人工股骨头置换术治疗,观察组采用PFNA治疗,比较两组各项手术治疗指标、髋关节功能评分、并发症发生情况。结果观察组患者手术时间、术中出血量均少于对照组(P均<0.05);观察组患者负重时间、下床活动时间、住院时间均长于对照组(P均<0.05)。两组患者术前、术后3个月Harris评分差异均无统计学意义(P均>0.05),术后6和12个月观察组Harris评分均高于对照组(P均<0.05)。观察组(5.45%)并发症总发生率低于对照组(18.18%)(P<0.05)。结论高龄股骨粗隆间骨折患者手术治疗,PFNA手术时间更短,术中出血量更少,并发症更低,髋关节功能恢复更快,值得推广。

Objective To explore the application of proximal femoral anti-rotation intramedullary nail(PFNA)and artificial femoral head replacement in elderly patients with intertrochanteric fracture,and to compare the therapeutic effect of the two methods.Methods A total of 110 elderly patients with intertrochanteric fracture of femur admitted to our hospital from July 2016 to June 2018 were selected as the research object,and were divided into control group(55 cases)and observation group(55 cases)according to the method of digital random table.The control group was treated with artificial femoral head replacement,while the observation group was treated with PFNA.The surgical treatment indexes,hip function scores and complications were compared between the two groups.Results The operation time,intraoperative bleeding volume and weight-bearing time of the observation group were less than those of the control group(P all<0.05).The activity time and hospitalization time of the observation group were longer than those of the control group(P all<0.05).There was no significant difference in Harris score between the control group and the observation group before and 3 months after operation(P all>0.05).Harris score of the observation group was higher than that of the control group 6 months after operation and 12 months after operation(P all<0.05).The total incidence of complications(18.18%)in the control group was higher than these and in the observation group(5.45%).The difference was statistically significant(P<0.05).Conclusion In the surgical treatment of elderly patients with intertrochanteric fracture of femur,PFNA operation time is shorter,intraoperative blood loss is less,complications are lower,and hip function recovery is faster,which is worthy of promotion.