Ⅲ型标准伽玛(γ)型髓内钉和股骨近端防旋髓内钉对股骨粗隆间骨折患者凝血功能及稳定性的影响

Effects of typeⅢstandard gamma(γ)intramedullary nail and proximal femoral nail antirotation on coagulation function and stability in patients with femoral intertrochanteric fractures

目的探讨Ⅲ型标准伽玛(γ)型髓内钉和股骨近端防旋髓内钉(PFNA)对股骨粗隆间骨折患者凝血功能及稳定性的影响。方法选取2017年1月至2020年1月收治的85例股骨粗隆间骨折患者,根据术式的不同将其分为A组(43例)和B组(42例)。A组采用Ⅲ型标准伽玛(γ)型髓内钉固定手术,B组采用PFNA固定手术。比较两组的手术指标、术后恢复指标、凝血功能指标及内固定术后稳定性。结果 A组的住院时间及下地行走时间均短于B组(P<0.05)。术后1个月,两组的PT、APTT均缩短,Fbg水平均降低,且A组优于B组(P<0.05)。A组内固定术后稳定率为95.35%,高于B组的78.57%(P<0.05)。结论采用Ⅲ型标准伽玛(γ)型髓内钉和PFNA治疗股骨粗隆间骨折均能取得较好的效果,不过Ⅲ型标准伽玛(γ)型髓内钉有助于加快患者术后恢复,改善患者的凝血功能和固定的稳定性。

Objective To explore the effects of typeⅢstandard gamma(γ)intramedullary nail and proximal femoral nail antirotation(PFNA)on coagulation function and stability in patients with femoral intertrochanteric fractures.Methods Eighty-five patients with femoral intertrochanteric fractures enrolled from January 2017 to January 2020 were selected and divided into group A(43 cases)and group B(42 cases)according to the different operation methods.The group A was treated with typeⅢstandard gamma(γ)intramedullary nail fixation,and the group B was treated with PFNA fixation.The operation indexes,postoperative recovery indexes,coagulation function indexes and postoperative stability of internal fixation were compared between the two groups.Results The hospitalization time and walking time in the group A were shorter than those in the group B(P<0.05).One month after operation,PT and APTT shortened and FBG level decreased in both groups,and those in the group A were better than the group B(P<0.05).The postoperative stability rate of internal fixation of the group A was 95.35%,which was higher than 78.57%of the group B(P<0.05).Conclusion Both typeⅢstandard gamma(γ)intramedullary nail and PFNA can achieve better results in the treatment of femoral intertrochanteric fractures,but typeⅢstandard gamma(γ)intramedullary nail is helpful to accelerate postoperative recovery,and improve coagulation function and stability of fixation of patients.