中西医结合对老年股骨粗隆间粉碎性骨折患者临床诊疗方法及疗效分析

Clinical Diagnosis and Treatment of Traditional Chinese Medicine and Western Medicine for Elderly Patients with Intertrochanteric Fracture

目的:分析反向股骨远端A0微创内固定系统(LISS)结合自拟方对老年股骨粗隆间粉碎性骨折患者临床诊疗方法及疗效情况。方法:回顾性分析2014年2月~2017年2月间在本院进行治疗的股骨粗隆间的粉碎性骨折患者167例,其中使用反向股骨远端LISS结合自拟方治疗的有69例,为观察组;使用动力髋螺钉(DHS)治疗的有98例,为对照组;观察两组患者手术中、手术后及Harris评分情况,使用ELISA法检测IL-6、TNF-α及IL-10水平变化情况。结果:观察组患者切口长度、出血量及手术时间均低于对照组,对比差异有统计学意义(P<0.05);两组患者在骨折平均愈合时间、内固定失效人数、骨折不愈合人数和畸形愈合方面对比差异无统计学意义(P>0.05);两组患者术后优良率及Harris评分对比差异无统计学意义(P>0.05);手术后两组患者血清IL-6及TNF-α含量明显下降,IL-10含量明显上升,与治疗前对比差异均有统计学意义(P<0.05),且观察组患者效果更佳,与对照组对比差异有统计学意义(P<0.05)。结论:反向股骨远端LISS结合中医治疗具有创伤小、固定可靠、手术时间短和骨折愈合率高等优点,值得在临床推广使用。

Objective: To analyze the clinical diagnosis and treatment of elderly patients with intertrochanteric fracture of femur by A0 minimally invasive internal fixation system(LISS) combined with traditional Chinese medicine treatment. Methods: A retrospective analysis from February 2014 to February 2017 in our hospital for treatment of intertrochanteric comminuted fracture in167 cases,including the use of reverse distal femoral LISS treatment in 69 cases,as the observation group; The use of dynamic hip screw(DHS) treatment of 98 cases,the controlled group; Observation score of the two groups of patients with surgery and after surgery and Harris,using ELISA method to detect the changes of IL-6,TNF-alpha and IL-10 level. Results: Patients with incision length,bleeding volume and operation time were lower than the controlled group,there was statistically significant difference(P<0. 05); Two patients in the average healing time of fracture,internal fixation failure,nonunion and deformity of the number of the number of healing in contrast there was no significant difference in fracture(P > 0. 05); No significant significant differences in the excellent rate and Harris score between the two groups of patients(P>0. 05); After the operation of the two groups of IL-6 and TNF-αin patients with serum concentrations were significantly decreased,IL-10 content increased significantly,compared with before treatment the differences were statistically significant(P<0. 05),and the observation group of patients with better effect,compared with the controlled group differences there was statistical significance(P<0. 05). Conclusion: Reverse distal femur LISS combined with traditional Chinese medicine has the advantages of small trauma,reliable fixation,short operation time and high rate of fracture healing,so it is worth popularizing in clinical practice.