股骨近端防旋髓内钉内固定术与股骨近端锁定加压钛板术治疗老年股骨粗隆间骨折患者的效果比较

Comparison of effects of proximal femoral nail anti-rotation internal fixation and proximal femoral locking compression titanium plate in treatment of elderly patients with intertrochanteric fractures of femur

目的:比较股骨近端防旋髓内钉内固定术(PFNA)与股骨近端锁定加压钛板术(LCP)治疗老年股骨粗隆间骨折(IFF)患者的效果。方法:回顾性分析2019年9月至2021年9月于该院行手术治疗的67例老年IFF患者的临床资料,根据手术方式不同将其分为对照组32例和研究组35例。对照组采用LCP治疗,研究组采用PFNA治疗,比较两组围术期相关指标水平、手术前后髋关节功能(髋关节Harris评分)、并发症发生率和术后1、7 d炎性因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平。结果:研究组手术时间、住院时间、骨折愈合时间均短于对照组,术中出血量低于对照组,差异有统计学意义(P<0.05);术后6个月,两组Harris评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为2.86%,低于对照组的21.88%,差异有统计学意义(P<0.05);术后7 d,两组IL-6、CRP水平均低于术后1 d,且研究组低于对照组,差异有统计学意义(P<0.05)。结论:PFNA治疗老年IFF患者可提高髋关节功能评分,降低围术期相关指标水平、炎性因子水平和并发症发生率,其效果优于LCP治疗。

Objective:To compare effects of proximal femoral nail anti-rotation(PFNA)and proximal femoral locking compression titanium plate(LCP)in treatment of elderly patients with intertrochanteric fractures of femur(IFF).Methods:The clinical data of 67 elderly patients with IFF who underwent surgical treatment from September 2019 to September 2021 were retrospectively analyzed.According to different surgical methods,they were divided into control group(32 cases)and study group(35 cases).The control group was treated with LCP,while the study group was treated with PFNA.The levels of perioperative related indexes,the hip function(Harris score of hip joint)before and after the surgery,the incidence of complications,and the levels of inflammatory factors[interleukin-6(IL-6),C-reactive protein(CRP)]1 and 7 days after the surgery were compared between the two groups.Results:The operation time,the hospitalization time and the fracture healing time of the study group were shorter than those of the control group,the intraoperative blood loss was lower than that of the control group,and the differences were statistically significant(P<0.05).6 months after the surgery,the Harris scores of the two groups were higher than those before the surgery,that of the study group was higher than that of the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the study group was 2.86%,which was lower than 21.88%in the control group,and the difference was statistically significant(P<0.05).Further,7 days after the surgery,the levels of IL-6 and CRP in the two groups were lower than those 1 day after the surgery,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:PFNA in the treatment of the elderly patients with IFF can improve the hip function scores and reduce the levels of perioperative related indexes,the level of inflammatory factors and the incidence of complications.Moreover,it is superior to LCP treatment.