股骨近端防旋髓内钉与动力髋螺钉治疗不稳定型股骨粗隆间骨折的临床研究

Clinical study of proximal femoral anti-rotation intramedullary nail and dynamic hip screw in the treatment of unstable intertrochanteric fracture of the femur

目的探究股骨近端防旋髓内钉与动力髋螺钉治疗不稳定型股骨粗隆间骨折的临床效果。方法以简单随机抽样法纳入2013年10月~2020年11月赣州市南康区中医院收治的80例不稳定型股骨粗隆间骨折患者作为研究对象,采用抽签法将其随机分为对照组和观察组,每组各40例,前者采用动力髋螺钉进行治疗,后者采用股骨近端防旋髓内钉进行治疗。对两组患者的手术相关指标、髋关节功能评分(Harris评分)、应激反应水平、生活质量(SF-36)评分、并发症发生情况进行统计学分析。结果观察组患者手术耗时、骨折愈合时间均短于对照组,术中总出血量少于对照组,Harris评分高于对照组,差异有统计学意义(P<0.05)。术前,两组患者的血管紧张素Ⅱ(AngⅡ)水平、超氧化物歧化酶(SOD)水平、SF-36评分比较,差异无统计学意义(P>0.05);术后观察组患者AngⅡ水平、SOD水平低于对照组,SF-36评分高于对照组,差异有统计学意义(P<0.05)。观察组患者的并发症总发生率(5.00%)低于对照组(20.00%),差异有统计学意义(P<0.05)。结论股骨近端防旋髓内钉较动力髋螺钉对不稳定型股骨粗隆间骨折患者治疗效果更好,应激反应更小,髋关节功能恢复更好,可优先选择。

Objective To explore the clinical effect of proximal femoral anti-rotation intramedullary nail and dynamic hip screw in the treatment of unstable intertrochanteric fracture of the femur.Methods A simple random sampling method was used to enroll 80 patients with unstable intertrochanteric fractures admitted to Nankang Traditional Chinese Medicine Hospital of Ganzhou City from October 2013 to November 2020 as the research objects.They were randomly divided into the control group and the observation group by lottery,40 cases in each group,the former was treated with dynamic hip screw,and the latter was treated with proximal femoral anti-rotation intramedullary nail.The operation-related indicators,hip joint function score(Harris score),stress response level,quality of life(SF-36)score,and incidence of complications of patients between the two groups were statistically analyzed.Results The operation time and fracture healing time of the observation group were shorter than those of the control group,the total blood loss during the operation was less than that of the control group,the Harris score was higher than that of the control group,and the differences were statistically significant(P<0.05).Before operation,there were no significant differences in the levels of angiotensinⅡ(AngⅡ),superoxide dismutase(SOD)and SF-36 score between the two groups(P>0.05).The AngⅡand SOD levels of the observation group were lower than those of the control group,and the SF-36 score was higher than that of the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group(5.00%)was lower than that in the control group(20.00%),and the difference was statistically significant(P<0.05).Conclusion Proximal femoral anti-rotation intramedullary nails are better than dynamic hip screws for the treatment of unstable femoral intertrochanteric fractures,with less stress response and better hip function recovery,which can be preferred.