老年股骨转子间骨折急诊闭合复位防旋股骨近端髓内钉内固定手术的治疗效果

Effect of Emergency Closed Reduction and Proximal Femoral Nail Antirotation Internal Fixation in Elderly Patients with Intertrochanteric Fracture

目的:分析老年股骨转子间骨折急诊闭合复位防旋股骨近端髓内钉(PFNA)内固定手术的治疗效果。方法:选取笔者所在科收治的老年股骨转子间骨折患者70例,将其随机分为两组,每组35例。对照组5~7 d后择期行闭合复位PFNA内固定手术治疗,观察组给予急诊闭合复位PFNA内固定手术治疗。比较两组术前1 d,术后3、7、14 d HGB、HCT。比较两组术中出血量及术后输血量、手术时间、术后下床活动时间、术后住院时间及并发症发生情况。结果:两组术前1 d HGB、HCT比较差异均无统计学意义(P>0.05);观察组术后3、7、14 d HGB、HCT均优于对照组,差异有统计学意义(P<0.05)。观察组术中出血量及术后输血量均少于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组手术时间比较差异无统计学意义(P>0.05)。观察组术后下床活动时间、术后住院时间均优于对照组,差异有统计学意义(P<0.05)。结论:老年股骨转子间骨折急诊闭合复位PFNA内固定手术的治疗效果确切,可有效减少术中出血量和并发症的发生,可缩短术后下床活动时间和术后住院时间。

Objective:To analyze the therapeutic effect of emergency closed reduction and proximal femoral nail antirotation(PFNA)internal fixation in elderly patients with intertrochanteric fracture.Method:A total of 70 elderly patients with intertrochanteric fractures admitted in our department were selected and randomly divided into two groups,with 35 case in each group.The control group received selective closed reduction and PFNA internal fixation surgery after 5 to 7 d.The observation group received emergency closed reduction and PFNA internal fixation surgery.HGB and HCT were compared between the two groups 1 d before surgery and 3,7,14 d after surgery.The intraoperative blood loss,postoperative blood transfusion,operation time,postoperative ambulation time,postoperative hospitalization time and complications of the two groups were compared.Result:There were no significant differences in HGB and HCT between the two groups 1 d before surgery(P>0.05).HGB and HCT of the observation group were better than those of the control group 3,7 and 14 d after surgery,the differences were statistically significant(P<0.05).The intraoperative blood loss and postoperative blood transfusion in the observation group were less than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).Postoperative ambulation time and postoperative hospitalization time in the observation group were better than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Emergency closed reduction and PFNA internal fixation in elderly patients with intertrochanteric fractures has a definite therapeutic effect,which can effectively reduce the intraoperative blood loss and complications,and shorten postoperative ambulation time and postoperative hospitalization time.