不同内固定手术对老年股骨粗隆间骨折患者围术期指标及术后免疫能力的影响

Impact on the Effects of Different Internal Fixation on Perioperative Indicators and Postoperative Immune Ability in Elderly Patients with Intertrochanteric Fractures

目的探讨不同内固定手术对老年股骨粗隆间骨折患者围术期指标及术后免疫能力的影响。方法将70例股骨粗隆间骨折老年患者随机分为两组,对照组采用动力髋螺钉(DHS)内固定治疗,观察组采用股骨近端防旋髓内钉(PFNA)内固定治疗。比较两组的围术期指标、免疫功能指标及术后并发症发生情况。结果观察组手术时间、骨折愈合时间及住院时间均短于对照组,术中出血量少于对照组(P<0.05)。治疗后,观察组CD3+、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。观察组术后并发症发生率低于对照组(P<0.05)。结论PFNA内固定治疗股骨粗隆间骨折的效果显著,有助于缩短术后康复时间,减少并发症发生,且对患者免疫能力的影响较小。

Objective To explore the impact of different internal fixation on perioperative indicators and postoperative immune ability in elderly patients with intertrochanteric fractures.Methods 70 elderly patients with intertrochanteric fractures were randomly divided into control group and observation group.The control group was given dynamic hip screw(DHS)internal fixation,and the observation group was given proximal femoral nail anti-rotation(PFNA)internal fixation.The perioperative indicators,immune function indicators and postoperative complications were compared between the two groups.Results The operation time,fracture healing time and hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).After treatment,the CD3+,CD4^(+)and CD4^(+)/CD8^(+)of the observation group were higher than those of the control group,and the CD8^(+)was lower than that of the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than in the control group(P<0.05).Conclusions PFNA internal fixation has significant effect in the treatment of intertrochanteric fractures,which can shorten the postoperative rehabilitation time,reduce the complications,and has little impact on the immune ability.