基于加速康复外科理念的骨水泥强化型防旋股骨近端髓内钉治疗在老年骨质疏松性股骨转子间骨折中的应用效果

Application effect of bone cement-reinforced anti-rotation proximal femoral nail antirotation based on the concept of enhanced recovery after surgery in the treatment of senile osteoporotic intertrochanteric fracture of femur

目的探讨基于加速康复外科(ERAS)理念的骨水泥强化型防旋股骨近端髓内钉(PFNA)治疗在老年骨质疏松性股骨转子间骨折中的应用效果。方法选取东台市人民医院2021年1月至2022年10月收治的40例老年骨质疏松性股骨转子间骨折患者为研究对象,采用随机数字表法分为对照组(20例)和观察组(20例)。对照组采用ERAS理念联合PFNA治疗,观察组采用ERAS理念联合骨水泥强化型PFNA治疗,并对两组进行为期6个月的随访。比较两组髋关节Harris评分优良率、髋关节活动角度、手术及恢复情况、生活质量及并发症。结果观察组术后6个月髋关节Harris评分优良率高于对照组,观察组住院时间、骨折愈合时间、术后下地行走时间、负重练习时间均短于对照组,总并发症发生率低于对照组,差异有统计学意义(P<0.05);两组的手术时间、术中出血量的比较,差异无统计学意义(P>0.05);观察组术后6个月的欧洲五维健康量表(ED-5Q)各项评分低于对照组,髋关节活动角度大于对照组,差异有统计学意义(P<0.05)。结论ERAS理念下的骨水泥强化型PFNA治疗老年骨质疏松性股骨转子间骨折患者能提高治疗优良率,提高患者生活质量,增加髋关节活动角度,且并发症发生率低。

Objective To explore the application effect of bone cement-reinforced anti-rotation proximal femoral nail antirotation(PFNA)based on the concept of enhanced recovery after surgery(ERAS)in the treatment of senile osteoporotic intertrochanteric fracture of femur.Methods A total of 40 senile patients with osteoporotic intertrochanteric fracture of femur admitted to Dongtai People's Hospital from January 2021 to October 2022 were selected as the research objects,and divided into the control group(20 cases)and the observation group(20 cases)by random number table method.The control group was treated with ERAS concept combined with PFNA,while the observation group was treated with ERAS concept combined with bone cement-reinforced anti-rotation PFNA.Both groups were followed up for 6 months.The excellent and good rate of Harris hip score,Angle of hip motion,operation and recovery,quality of life and complications were compared between the two groups.Results The excellent and good rate of hip Harris scores in the observation group was higher than that in the control group 6 months after operation,the hospitalization time,fracture healing time,postoperative walking time and weight-bearing exercise time in the observation group were shorter than those in the control group,and the total incidence of complications was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).The European five-dimensional health scale(ED-5Q)scores of the observation group were lower than those of the control group,and the activity of hip motion Angle were higher than those of the control groupafter 6 months operation,the differences were statistically significant(P<0.05).Conclusion The treatment of senile patients with osteoporotic intertrochanteric fracture with bone cement-reinforced anti-rotation PFNA under ERAS concept can improve the rate of good treatment,improve the quality of life of patients,increase the Angle of hip motion,and reduce the incidence of complications.