鲑降钙素辅助股骨近端防旋髓内钉内固定对老年股骨粗隆间骨折的临床疗效及其对患者骨密度和骨代谢的影响

Clinical effect of calcitonin(salmon)assisted proximal femoral nail anti-rotation fixation on femoral intertrochanteric fracture in the elderly and its influence on bone mineral density and bone metabolism in patient

目的探讨鲑降钙素辅助股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)内固定对老年股骨粗隆间骨折的临床疗效及其对患者骨密度和骨代谢的影响。方法选取2018年1月至2019年6月中国人民解放军联勤保障部队第九六〇医院收治的102例老年股骨粗隆间骨折患者为研究对象,依据随机数字表法将其分为观察组和对照组,每组各51例。两组患者均采取PFNA内固定治疗。对照组患者术后给予碳酸钙D3片,观察组患者在对照组基础上加用鲑降钙素治疗,疗程均为3个月。比较两组患者疗效、骨折愈合时间、术后1 d和术后3个月骨密度及骨代谢变化。结果观察组患者优良率显著高于对照组(P<0.05),骨折愈合时间显著短于对照组(P<0.05)。术后3个月,两组患者股骨颈和股骨大粗隆骨密度均显著高于本组术后1 d(均P<0.05),且观察组患者股骨颈和股骨大粗隆骨密度、骨钙素和骨碱性磷酸酶水平均显著高于同期对照组(均P<0.05),血清Ⅰ型前胶原氨基端前肽水平显著低于同期对照组(P<0.05)。结论鲑降钙素辅助PFNA内固定治疗老年股骨粗隆间骨折的临床效果较好,有助于促进术后骨折愈合,增加骨密度,改善骨代谢。

Objective To investigate the effect of calcitonin(salmon)assisted proximal femoral nail anti-rotation(PFNA)fixation on femoral intertrochanteric fracture in the elderly and its influence on bone mineral density and bone metabolism in patient.Method A total of 102 elderly patients with femoral intertrochanteric fracture admitted the 960th Hospital of the PLA Joint Logistics Support Force from January 2018 to June 2019 were selected as the study objects,and they were divided into observation group and control group according to random number table method,with 51 cases in each group.The two groups patients were treated with PFNA internal fixation.Patients in control group were given calcium carbonate D3 tablets after operation,and patients in observation group were treated with calcitonin(salmon)on the basis of control group,the course of treatment was 3 months.The efficacy,fracture healing time,bone mineral density and bone metabolism 1 day and 3 months after surgery of the two groups were compared.Result The excellent and good rate of patients in observation group was significantly higher than that in control group(P<0.05),the fracture healing time was significantly shorter than that in control group(P<0.05).3 months after the operation,the bone mineral density of femoral neck and greater trochanter in both groups were significantly higher than those 1 day after the operation(all P<0.05),and bone mineral density of femoral neck and greater trochanter,the levels of osteocalcin and bone alkaline phosphatase in observation group were significantly higher than those in control group(all P<0.05),the level of serum procollagen typeⅠN-terminal propetide in observation group was significantly lower than that in control group(P<0.05).Conclusion Calcitonin(salmon)assisted PFNA internal fixation has a good clinical effect on femoral intertrochanteric fractures in elderly patient,which is helpful to promote postoperative fracture healing,increase bone mineral density and improve bone metabolism.