| 陈 刚,刘 玺,马建武,许 喆,李 志,周孝辉.股骨近端防旋髓内钉与人工股骨头置换术治疗老年不稳定股骨转子间骨折的比较研究[J].,2019,19(3):531-535 |
| 股骨近端防旋髓内钉与人工股骨头置换术治疗老年不稳定股骨转子间骨折的比较研究 |
| Comparative Study on Proximal Femoral Nail Antirotation and Artificial Femoral Head Replacement in Treatment of Unstable Femoral Intertrochanteric Fractures in the Elderly |
| 投稿时间：2018-04-27 修订日期：2018-05-20 |
| DOI：10.13241/j.cnki.pmb.2019.03.031 |
| 中文关键词: 股骨近端防旋髓内钉 人工股骨头置换术 老年 不稳定股骨转子间骨折 疗效 |
| 英文关键词: Proximal femoral nail antirotation Artificial femoral head replacement Elderly Unstable femoral intertrochanteric fractures Comparison |
| 基金项目:青海省科技计划项目（2012Z737） |
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| 中文摘要: |
| 摘要 目的：比较股骨近端防旋髓内钉（PFNA）与人工股骨头置换术（FHR）治疗老年不稳定股骨转子间骨折（UFIF）的疗效。方法：选择2015年9月到2017年6月期间在我院接受手术治疗的老年UFIF患者156例进行研究。根据手术方案的不同将患者分成观察组（n=78）及对照组（n=78），其中观察组给予FHR术式治疗，对照组给予PFNA术式治疗，随访6个月，比较两组患者的疗效、并发症以及手术时间、切口长度、术中出血量、下床时间等手术指标，并比较两组患者术前、术后1个月、术后3个月、术后6个月的视觉模拟量表（VAS）评分。结果：观察组的优良率为92.31%，与对照组的88.46%相比，差异无统计学意义（P>0.05）。观察组的下床时间明显少于对照组，但手术时间、切口长度以及术中出血量明显大于对照组（P<0.05）。观察组术后输血的发生率明显高于对照组（P<0.05），而两组患者的内植物松动、骨折不愈合以及下肢深静脉血栓的发生率比较差异无统计学意义（P>0.05）。两组患者术后1个月、术后3个月、术后6个月的VAS评分均低于术前，且随着时间的推移，VAS评分呈逐渐降低的趋势，差异有统计学意义（P<0.05）。结论：对于老年UFIF患者而言，PFNA术式及FHR术式的治疗效果及安全性均较好，临床上可根据患者的实际骨折程度选择合适的术式。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the therapeutic effect of proximal femoral nail antirotation (PFNA) and artificial femoral head replacement (FHR) in the treatment of unstable femoral intertrochanteric fractures (UFIF) in the elderly. Methods: 156 elderly patients with UFIF who were underwent surgical treatment in our hospital from September 2015 to June 2017 were selected to carry out research.The patients were divided into the observation group (n=78) and the control group (n=78) according to the different surgical procedures.The observation group was treated with FHR, and the control group was treated with PFNA. The patients were followed up for 6 months,the effects, complications, the operative time, incision length, intraoperative bleeding volume and out of bed time were observed in the two groups, the visual analogue scale (VAS) scores of two groups before operation, 1 months after operation, 3 months after operation and 6 months after operation were evaluated. Results: The excellent and good rate of the observation group was 92.31%, compared with 88.46% of the control group, the difference was not statistically significant (P>0.05). The out of bed time in the observation group was significantly less than the control group, however, the operative time, incision length and intraoperative bleeding volume were significantly higher than the control group (P<0.05). The incidence of postoperative blood transfusion in the observation group was significantly higher than that of the control group (P<0.05), there was no significant difference in the incidence of internal plant loosening, nonunion of fracture and deep vein thrombosis of lower extremities in the two groups (P>0.05). The VAS scores of patients in two groups at 1 months, 3 months and 6 months after operation were all lower than those before operation, and the VAS score was gradually decreased with time going on, the difference was statistically significant (P<0.05). Conclusion: The effect and safety of PFNA and FHR were better for the elderly UFIF patients. The appropriate surgical procedure can be selected according to the actual degree of fracture of the patient. |
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