PFNA内固定术对老年股骨粗隆间骨折患者髋关节功能的影响

Effect of PFNA internal fixation on hip joint function in elderly patients with intertrochanteric femoral fracture

目的探讨股骨近端防旋髓内钉(PFNA)内固定术对老年股骨粗隆间骨折(IFF)患者髋关节功能的影响。方法选取82例老年IFF患者,依据入院编号的奇偶性将其分为观察组(PFNA内固定术)与对照组[全髋关节置换术(THA)],各41例。比较两组的临床效果。结果术后1、3个月,观察组的Harris评分及关节骨密度均低于对照组(P<0.05);术后6、9、12个月,观察组的Harris评分高于对照组(P<0.05)。术后2周,观察组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平及视觉模拟评分法(VAS)评分均低于对照组(P<0.05)。观察组的术后并发症总发生率低于对照组(P<0.05)。结论相比THA,PFNA内固定术治疗老年IFF患者的效果更佳,可改善炎症因子水平及疼痛程度,不易引发基础疾病恶化,降低手术风险,提升髋关节功能远期恢复效果。

Objective To explore the effect of proximal femoral nail antirotation(PFNA)internal fixation on hip joint function in elderly patients with intertrochanteric femoral fracture(IFF).Methods A total of 82 IFF elderly patients were selected,according to the parity of admission numbers,the patients were divided into observation group(PFNA internal fixation)and control group[total hip arthroplasty(THA)],with 41 cases in each group.The clinical effects of the two groups were compared.Results At 1 and 3 months after operation,the Harris score and joint bone mineral density in the observation group were lower than those in the control group(P<0.05);at 6,9 and 12 months after operation,the Harris score in the observation group was higher than that in the control group(P<0.05).At 2 weeks after operation,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and Visual Analogue Scale(VAS)score in the observation group were lower than those in the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion Compared with THA,PFNA internal fixation in the treatment of elderly patients with IFF has a better effect,which can ameliorate the levels of inflammatory factors and the degree of pain,not easily cause the deterioration of underlying diseases,reduce the risk of surgery,and improve the long-term recovery effect of hip joint function.