不同手术方式治疗老年股骨粗隆区骨折的效果观察

Effects of different surgical methods for elderly patients with femoral intertrochanteric fractures

目的:对比股骨近端防旋髓内钉(PFNA)与人工股骨头置换术治疗老年股骨粗隆区骨折的效果。方法:选取潜山市立医院2019年6月—2021年6月收治的66例老年股骨粗隆区骨折患者,采用随机数字表法分为PFNA组(n=32)和人工股骨头置换术组(n=34),PFNA组行PFNA治疗,人工股骨头置换术组行人工股骨头置换术治疗。比较两组匹兹堡睡眠质量指数量表(PSQI)、视觉模拟评分法(VAS)、Harris髋关节功能评分、围手术期指标。结果:术后3、7d时人工股骨头置换术组PSQI、VAS得分均低于PFNA组,差异有统计学意义(P<0.05),术后1个月,Harris髋关节功能评分高于PFNA组,差异有统计学意义(P<0.05);人工股骨头置换术组术中失血量多于PFNA组,手术时间长于PFNA组,住院时间、负重活动时间短于PFNA组,术后并发症总发生率低于PFNA组,差异有统计学意义(P<0.05)。结论:老年股骨粗隆区骨折治疗中行人工股骨头置换术有助于缓解疼痛,改善睡眠质量,对恢复髋关节功能、减少并发症、缩短住院时间均有益处。

Objective To compare the effects of proximal femoral nail anti-rotation(PFNA)and artificial femoral head replacement in the treatment of elderly femoral intertrochanteric fractures.Methods 66 elderly patients with femoral intertrochanteric fractures admitted to Qianshan Municipal Hospital were enrolled between June 2019 and June 2021.According to the different types of surgery,the patients were divided into PFNA group(PFNA treatment,n=32)and artificial femoral head replacement group(artificial femoral head replacement,n=34).Pittsburgh Sleep Quality Index(PSQI),Visual Analogue Scale(VAS),Harris hip function score and perioperative indicators were compared between the two groups.Results The PSQI score and VAS score in artificial femoral head replacement group at 3 and 7 days after surgery were lower than those in PFNA group(P<0.05).At 1 month after surgery,the Harris hip function score was obviously higher than that in PFNA group the difference was statistically significant(P<0.05).The intraoperative blood loss in artificial femoral head replacement group was significantly more than that in PFNA group,and the surgical time was obviously longer while the hospital stay and weight-bearing activity time were significantly shorter compared to PFNA group,and the total incidence rate of postoperative complications was lower compared with that in PFNA group the difference was statistically significant(P<0.05).Conclusion Artificial femoral head replacement in the treatment of elderly femoral intertrochanteric fractures can help relieve pain and improves sleep quality,and it is beneficial to restoring hip function,reducing complications and shortening hospital stay.