PFNA与FHR 2种手术方式治疗老年人股骨转子间骨折疗效比较  

Comparing the efficacy of two surgical methods both PFNA and FHR in elderly patients with intertrochanteric fracture

作　　者：王和平[1] 孙学斌[2] 邓强[2] 杨永强[1] 徐建华[1] 陈屹泉 

机构地区：[1]新疆生产建设兵团农二师焉耆医院骨科,新疆库尔勒841300 [2]新疆医科大学第一附属医院骨科中心,乌鲁木齐830054

出　　处：《新疆医科大学学报》2014年第4期478-481,共4页Journal of Xinjiang Medical University

基　　金：新疆医科大学第一附属医院科研专项基金(2010ZZGC04)

摘　　要：目的比较股骨近端防旋髓内钉(PFNA)与人工股骨头置换(FHR)2种手术方式治疗老年人股骨转子间骨折的临床疗效。方法按照手术方法将2009年4月-2013年4月收治的88例年龄≥75岁患者股骨转子间骨折患者分为股骨近端防旋髓内钉组(PFNA组)、人工股骨头置换组(FHR组)。比较两组手术时间、出血量、术后血红蛋白下降值、术后并发症、卧床时间、Harris髋关节评分。结果两组Harris髋关节评分差异无统计学意义(P>0.05);FHR组卧床时间较PFNA组短,差异有统计学意义(P<0.05);PFNA组在手术时间、出血量、血红蛋白下降及术后并发症方面优于FHR组,差异有统计学意义(P<0.05)。结论 PFNA和FHR均是治疗老年人股骨粗隆间骨折的有效方法,2种手术方式各有其优缺点:FHR术后卧床时间短,可早期下地活动,而PFNA具有手术时间短、出血量少、血红蛋白下降少及术后并发症少的优点,PFNA较FHR更适合于老年股骨转子间骨折的治疗。Objective To compare the clinical efficacy of two surgical methods with Proximal Femoral Nail Antirotation （PFNA） fixed and artificial femoral head replacement （FHR） in elderly patients with inter- trochanteric fracture. Methods 88 cases of patients over the age of 75 with intertrochanteric fractures treated between April 2009 to April 2013 were divided into PFNA and FHR groups according to the surgical approach. Operation time, intraoperative bleeding, hemoglobin decline before and after operation, postop- erative complications, bed time, Harris hip score were compared. Results There was no statistical signifi- cance in the difference of Harris hip scores （P〉0.05） ; bed time of FHR group was shorter than that of PFNA group, which was statistically significant （P〈0.05）. Operation time, intraoperative bleeding, he moglobin decline and postoperative complications of PFNA group were superior than that of FHR group, which was also statistically significant （P〈0.05）. Conclusion Both of PFNA and FHR were effective methods of the treatment for the elderly with intertrochanteric fracture. But they had their advantages and disadvantages：bed time in FHR group was shorter, which was a favor of weight--bearing activity; But PFNA had many advantages, such as short operating time, less intraoperative bleeding, less hemoglobin decline, little postoperative complication. So PFNA is more suitable for the treatment of intertrochanteric fracture in elderly patients than FHR.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉 人工股骨头置换 

分 类 号：R683.42[医药卫生—骨科学]