股骨近端锁定钢板与PFNA治疗股骨近端骨折的临床效果比较

Comparison of clinical effect of proximal femoral locking plate and PFNA in the treatment of proximal femoral fracture

目的比较股骨近端锁定钢板与股骨近端防旋髓内钉(PFNA)治疗股骨近端骨折的临床效果。方法选取2017年1月至2021年1月收治的78例股骨近端骨折患者作为研究对象,遵循随机原则将其分为对照组(n=39)与研究组(n=39)。对照组开展股骨近端锁定钢板治疗,研究组开展PFNA治疗。比较两组的临床疗效、手术情况、术后康复时间、并发症发生情况、髋关节功能评分、生活质量评分。结果研究组的治疗优良率为97.44%,显著高于对照组的84.62%,差异具有统计学意义(P<0.05)。研究组的手术时间短于对照组,术中出血量少于对照组,手术切口长度小于对照组,差异具有统计学意义(P<0.05)。研究组的术后骨折愈合时间、下床活动时间、负重行走时间、住院时间短于对照组,差异具有统计学意义(P<0.05)。术后1、3个月,研究组的髋关节功能(跛行程度、疼痛、行走距离、行走辅助支持物、功能情况、活动范围)评分高于对照组,差异具有统计学意义(P<0.05)。术后3个月,两组的生理健康、心理健康、周围环境、社会关系评分均高于治疗前,且研究组高于对照组(P<0.05)。结论相较于股骨近端锁定钢板治疗,PFNA治疗更能提高股骨近端骨折患者的手术效果及术后康复情况,减少并发症的发生,改善患者的髋关节功能及生活质量,值得临床推广应用。

Objective To compare the clinical effect of proximal femoral locking plate and proximal femoral nail anti-rotation(PFNA)in the treatment of proximal femoral fracture.Methods A total of 78 patients with proximal femoral fracture treated from January 2017 to January 2021 were selected as the research objects.The patients were divided into control group(n=39)and study group(n=39)according to random principle.The control group was treated with proximal femoral locking plate,and the study group was treated with PFNA.The clinical efficacy,operation,postoperative rehabilitation time,occurrence of complications,hip function scores and quality of life score were compared between the two groups.Results The excellent and good rate of treatment in the study group was 97.44%,which was significantly higher than 84.62%in the control group,and the difference was statistically significant(P<0.05).The operation time of the study group was shorter than that of the control group,the amount of intraoperative bleeding was less than that of the control group,the surgical incision length was less than that of the control group,and the differences were statistically significant(P<0.05).The postoperative fracture healing time,out of bed activity time,weight-bearing walking time and hospital stay in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).At 1 and 3 months after operation,the scores of hip function(claudication degree,pain,walking distance,walking aids,function and range of motion)in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Three months after operation,the scores of physical health,mental health,surrounding environment and social relations in the two groups were higher than those before treatment,and those in the study group were higher than the control group(P<0.05).Conclusion Compared with the proximal femoral locking plate treatment,PFNA treatment can better improve the surgical effect and postoperative rehabilitation,reduce the incidence of complications and ameliorate the hip function and quality of life of patients with proximal femoral fracture,which is worthy of clinical promotion and application.