股骨近端防旋髓内钉内固定术治疗老年股骨转子间骨折患者的效果观察

Observation on the Effect of Proximal Femoral Nail Antirotation Internal Fixation Surgery in the Treatment of Elderly Patients with Intertrochanteric Fracture of Femur

目的:探讨股骨近端防旋髓内钉内固定术治疗老年股骨转子间骨折患者的效果。方法:选择2020年3月—2023年3月乐安县人民医院收治的60例老年股骨转子间骨折患者作为研究对象,根据随机数字表法将其分为试验组和对照组,各30例,试验组采用股骨近端防旋髓内钉固定术治疗,对照组采用股骨近端锁定钢板固定术治疗,比较两组围手术期指标、血清炎症因子水平、髋关节功能恢复情况、并发症发生情况。结果:与对照组比较,试验组手术时间、术中透视时间、切口长度均更短,术中失血量和血红蛋白丢失量均更少,差异均有统计学意义(P<0.05)。术后1周,两组白细胞介素-6、白细胞介素-10、肿瘤坏死因子均较术前提高,但试验组均低于对照组,差异均有统计学意义(P<0.05)。术后6个月,两组Harris髋关节功能量表各维度评分均较术前提高,且试验组均高于对照组,试验组的髋关节恢复优良率93.33%高于对照组的73.33%,差异均有统计学意义(P<0.05)。试验组并发症发生率3.33%低于对照组的20.00%,差异有统计学意义(P<0.05)。结论:股骨近端防旋髓内钉内固定术用于治疗老年股骨转子间骨折,有助于改善围手术期指标和炎症水平,提高术后髋关节康复效果,减少并发症。

Objective:To investigate the effect of internal fixation of proximal femoral nail antirotation internal fixation surgery in the treatment of elderly patients with intertrochanteric fracture of femur.Methods:Sixty elderly patients with intertrochanteric fracture of femur in People's Hospital of Le'an County from March 2020 to March 2023 were selected as the study objects,and were divided into an experimental group and a control group according to random number table method,with 30 cases in each group.The experimental group received proximal femoral nail antirotation internal fixation surgery,and the control group received proximal femur locking plate internal fixation surgery.Perioperative indexes,serum inflammatory factor levels,hip function recovery and complications were compared between the two groups.Results:Compared with the control group,the operation time,intraoperative fluoroscopy time and incision length of the experimental group were shorter,and the intraoperative blood loss and hemoglobin loss were less than before surgery,the differences were statistically significant(P<0.05).One week after surgery,serum interleukin-6,interleukin-10 and tumor necrosis factor were higher than before surgery,but the experimental groups were lower than that in the control group,the differences were statistically significant(P<0.05).Six months after surgery,all aspects in the Harris Hip Function Scale scores of both groups were improved than before surgery,and the experimental group were higher than those of the control group,and the excellent and good rate of hip recovery in the test group was 93.33%higher than 73.33%in the control group,with statistical significances(P<0.05).The complication rate of experimental group was 3.33%lower than 20.00%of the control group,the difference was statistically significant(P<0.05).Conclusion:The use of proximal femoral nail antirotation internal fixation surgery in the treatment of elderly patients with intertrochanteric fractures can improve perioperative indexes and inflammation levels,improve postoperative hip rehabilitation and reduce complications.