老年股骨粗隆间骨折患者的动力髋螺钉与防旋髓内钉内固定治疗对创伤应激指标、髋关节功能的影响分析

Effects of Dynamic Hip Screw and Proximal Femoral Nail on Trauma Stress Indicators and Hip Joint Function Anti-rotation in Elderly Patients with Intertrochanteric Fractures of the Femur

目的 探究老年股骨粗隆间骨折(intertrochanteric fracture of femur, IFF)患者采用动力髋螺钉(dynamic hip screw, DHS)与防旋髓内钉内固定(proximal femoral nail anti-rotation, PFNA)治疗的临床疗效。方法 方便选取2021年1—12月厦门市长庚医院骨科收治的106例老年IFF患者为研究对象,依据手术方式的不同分为A组(53例,DHS内固定术),B组(53例,PFNA内固定术),对比两组患者髋关节功能、创伤应激指标与手术指标。结果 B组手术时间、住院时间均短于A组,术中出血量少于A组,差异有统计学意义(P均<0.05)。术后1 d、3 d,B组血清去甲肾上腺素、血管紧张素Ⅱ水平均低于A组,差异有统计学意义(P均<0.05)。术后,B组Harris评分优良率为94.34%(50/53)高于A组的79.25%(42/53),差异有统计学意义(χ^(2)=5.267,P<0.05)。结论 老年IFF患者选择PFNA治疗,与DHS治疗相比,创伤小,住院时间短,髋关节功能恢复理想,且术后创伤应激小。

Objective To explore the clinical efficacy of dynamic hip screw(DHS)and proximal femoral nail anti-rotation(PFNA)on elderly patients with intertrochanteric fracture of femur(IFF).Methods 106 elderly patients with IFF admitted to the Department of Orthopedics of Xiamen Changgeng Hospital from January to December 2021 were conveniently selected as the study objects.According to different surgical methods,they were divided into group A(53 cases,using DHS internal fixation)and group B(53 cases,using PFNA internal fixation),and the hip joint function,traumatic stress indexes and surgery index of the two groups were compared.Results The operation time and hospital stay in group B were shorter than those in group A,and the intraoperative blood loss was less than that in group A,the differences were statistically significant(all P<0.05).On the 1 day and 3 days after operation,serum norepinephrine and angiotensinⅡlevels in group B were lower than those in group A,and the differences were statistically significant(all P<0.05).After operation,the Harris score of group B was 94.34%(50/53)higher than that of group A 79.25%(42/53),and the difference was statistically significant(χ^(2)=5.267,P<0.05).Conclusion For elderly IFF patients,choosing PFNA treatment has smaller trauma,shorter hospital stay,more ideal hip joint function recovery,and less traumatic stress caused by surgery compared to DHS.