不同手术方式对股骨粗隆间骨折合并直肠癌患者凝血功能及预后的影响

Effects of different surgical methods on the coagulation function and prognosis in patients with femoral intertrochanteric fracture complicated with rectal cancer

目的探讨不同手术方式在股骨粗隆间骨折合并直肠癌患者中的应用价值。方法选取2015年4月至2018年4月间中南大学湘雅医学院附属第二医院收治的90例股骨粗隆间骨折合并直肠癌患者,采用数字表法随机分为观察组与对照组,每组45例。观察组患者采用防旋股骨近端髓内钉治疗方案,对照组患者采用动力髋螺钉治疗方案,比较两组患者手术前后凝血功能变化情况、并发症发生情况及手术效果。结果手术前后,两组间患者凝血功能指标比较,差异均无统计学意义(均P> 0. 05)。观察组患者术后并发症总发生率为4. 4%(2例),低于对照组的22. 2%(10例),差异有统计学意义(P <0. 05)。观察组患者手术总有效率为97. 8%(44例),高于对照组的80. 0%(36例),差异有统计学意义(P <0. 05)。结论动力髋螺钉与防旋股骨近端髓内钉治疗方案均可改善患者的凝血功能,促进身体康复,但防旋股骨近端髓内钉治疗方案可有效降低术后并发症的发生率,手术效果更佳。

Objective To observe the application significance of different surgical methods in patients with femoral intertrochanteric fracture complicated with rectal cancer. Methods A total of 90 patients with femoral intertrochanteric fracture complicated with rectal cancer admitted to Second Affiliated Hospital,Xiangya Medical College,Zhongnan University from April 2015 to April 2018 were randomly selected. Patients were divided into an observation group and a control group with 45 patients each by random number table method. The observation group was treated with proximal femoral nail antirotation while the control group was treated with dynamic hip screw. Changes in coagulation function,complications,and the treatment efficacy were compared between the two groups. Results There was no statistical significance in coagulation function between the two groups before the operation( P < 0. 05). The incidence of postoperative complications was 4. 4%( 2 patients) which was significantly lower than 22. 2%( 10 aptients) in the control group( P < 0. 05). The treatment efficacy was 97. 8%( 44 patients) in the observation group which was highier than 80. 0%( 36 patients) of the control group( P < 0. 05). Conclusion Both dynamic hip screw and proximal femoral nail antirotation treatment programs can improve patients’ coagulation function and physical rehabilitation,but proximal femoral nail antirotation can effectively reduce the incidence of postoperative complications,and has a more significant value in improving the surgical efficacy.