分析早期行股骨近端螺旋刀片抗旋髓内钉(PFNA)手术治疗老年股骨转子间骨折的疗效

Objective to Analyze the Effect of Proximal Femoral Nail Antirotation(PFNA)in the Treatment of Elderly Intertrochanteric Fractures

目的:探讨早期行股骨近端螺旋刀片抗旋髓内钉(PFNA)手术治疗老年股骨转子间骨折的效果。方法:本研究所选40例老年股骨转子间骨折患者均为本院2017年1月-2020年5月接收,依据随机数字表法分组,对照组20例与观察组20例分别开展人工股骨头置换术与股骨近端螺旋刀片抗旋髓内钉手术,对临床治疗效果进行对比分析。结果:骨折愈合时间、下床负重时间、引流量、手术时间、术中出血量和切口长度方面,观察组均比对照组优,差异明显(P<0.05);并发症发生率和治疗总有效率方面,对照组分别是20.00%和65.00%,观察组分别是5.00%和95.00%,观察组比对照组优,差异显著(P<0.05);TNF-α、IL-6及IL-10方面,2组治疗前对比,差异较小(P>0.05);观察组治疗后均比对照组低,差异明显(P<0.05);Hrris评分方面,术.后1个月及术后2个月,观察组与对照组相比,无明显差异(P>0.05)。结论:老年股骨转子间骨折临床治疗过程中,实施股骨近端螺旋刀片抗旋髓内钉治疗,不仅可以提高临床治疗效果,降低并发症发生率,同时可以加快骨折愈合速度,减少术中血流量,值得临床进一步采纳、推广。

Objective:To investigate the efct of proximal femoral spiral blade anti-rotation intramedullary nail(PFNA)in the treat-ment of senile intertrochanteric fracture.Methods:This research selected 40 cases of elderly patients with femoral fracture between the ro-tor is the hospital between January 2017 and May 2020,according to random number table method group,control group(20 cases)and observation group(20 cases),respectively,to carry out the artificial femoral head replacement and proximal femur spiral blade rotary in-tramedullary nail surgery,resistance to the clinical treatment effeet were analyzed.Results:In terms of fracture healing time,weight-bearing time out of bed,drainage volume,operation time,intraoperative blood loss and incision length,the observation group was superior to the control group,with significant differences(P<0.05).In terms of complication rate and total effective rate of treatment,the control group was 30.00%and 65.00%,respectively,and the observation group was 5.00%and 95.00%,respectively.The observation group was superior to the control group,with significant differences(P<0.05).In terms of TNF-α,il-6 and il-10,there was lttle differ-ence between the two groups before treatment(P>0.05).After treatment,the observation group was lower than the control group,with significant difference(P<0.05).Harris score showed no significant difference between the observation group and the control group 1 month and 2 months after surgery(P>0.05).Conclusion:In the clinical treatment of senile intertrochanteric fractures,the application of proximal femoral spiral blade anti-rotation intramedullary nail treatment can not only improve the clinical treatment ffct,reduce the in-cidence of complications,but also accelerate the speed of fracture healing and reduce intraoperative blood loss,which is worthy of further clinical adoption and promotion.