探讨股骨近端髓内钉治疗股骨粗隆骨折的临床效果

Investigation on the Clinical Effect of Proximal Femoral Intramedullary Nailing in the Treatment of Femoral Trochanteric Fractures

目的分析股骨近端髓内钉治疗股骨粗隆骨折的临床效果。方法随机选择该院2018年1月—2020年3月收治的股骨粗隆骨折患者70例为研究对象,结合数字随机表法分组,每组35例,对照组患者给予动力髋螺钉治疗,观察组给予股骨近端髓内钉手术。比较两组手术时间、出血总量、术后开始下床时间、总住院时间,治疗前后患者髋关节功能Harris评分、疼痛VAS评分,关节功能恢复优良率及并发症。结果观察组手术时间、出血总量、术后开始下床时间、总住院时间(66.25±6.25)min、(158.21±22.55)mL、(6.21±1.21)d、(12.35±2.51)d优于对照组(109.16±9.94)min、(321.25±43.11)mL、(12.26±2.91)d、(16.12±3.18)d,差异有统计学意义(t=21.620、19.826、11.357、5.505,P<0.05)。治疗后观察组Harris评分(92.05±2.23)分高于对照组,VAS评分(2.65±0.21)分低于对照组,差异有统计学意义(t=13.203、2.492,P<0.05)。观察组关节功能恢复优良率94.29%高于对照组74.29%,差异有统计学意义(χ^(2)=5.285,P<0.05)。观察组并发症发生率为5.71%,低于对照组(25.71%),差异有统计学意义(χ^(2)=5.285,P<0.05)。结论股骨近端髓内钉手术治疗股骨粗隆骨折的效果确切,其应用促使患者关节功能显著提升,痛苦程度明显减轻,减少并发症的发生,可加速患者术后的恢复进度。

Objective To analyze the clinical effect of proximal femoral nail in the treatment of femoral trochanteric fractures.Methods A total of 70 patients with femoral trochanteric fractures who were admitted to the hospital from January 2018 to March 2020 were randomly selected as the study objects,and divided into groups based on a random table of numbers,35 cases in each group.The patients in the control group were treated with dynamic hip screws.The observation group was given proximal femoral nail surgery.The operation time,total blood loss,time to get out of bed after operation,total hospital stay,Harris score of hip joint function,VAS score of pain before and after treatment,excellent and good rate of joint function recovery,and complications were compared between the two groups.Results The operation time,total amount of bleeding,time to get out of bed after operation,and total hospitalization time in the observation group were(66.25±6.25)min,(158.21±22.55)mL,(6.21±1.21)d,(12.35±2.51)d,which were better than those in the control group(109.16±9.94)min,(321.25±43.11)mL,(12.26±2.91)d,(16.12±3.18)d,the difference was statistically significant(t=21.620,19.826,11.357,5.505,P<0.05).After treatment,the Harris score in the observation group were(92.05±2.23)points,which were higher than those in the control group,and the VAS score was(2.65±0.21)points,which was lower than that in the control group,the difference was statistically significant(t=13.203,2.492,P<0.05).The excellent and good rate of joint function recovery in the observation group was 94.29%,which was higher than that in the control group 74.29%,the difference was statistically significant(χ^(2)=5.285,P<0.05).The incidence of complications in the observation group was 5.71%lower than that in the control group 25.71%,the difference was statistically significant(χ^(2)=5.285,P<0.05).Conclusion The treatment effect of proximal femoral nail surgery for femoral trochanteric fractures is definite.Its application can significantly improve the joint function of patients,relieve pain,reduce the occurrence of complications,and accelerate the recovery progress of patients after surgery.