PFNA内固定在老年人股骨转子间骨折的手术效果及对髋关节功能改善效果  

The Effect of PFNA Internal Fixation in the Treatment of Intertrochanteric Fractures in Elderly Patients

作　　者：曹博[1] 史永涛 侯海斌[1] 宗龙泽[1] 白东昱 CAO Bo;SHI Yong-tao;HOU Hai-bin;ZONG Long-ze;BAI Dong-yu(Affiliated Hospital of Yan'an University, joint surgery, Yan'an, Shaanxi,716000, China)

机构地区：[1]延安大学附属医院关节外科,陕西延安716000

出　　处：《现代生物医学进展》2018年第21期4114-4117,共4页Progress in Modern Biomedicine

基　　金：陕西省自然科学基金项目(2011JM4019)

摘　　要：目的:研究股骨近端螺旋刀片抗旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折的效果及对髋关节功能影响。方法:研究对象选取我院2012年8月到2015年5月间收治的老年股骨转子间骨折患者86例,采用随机数字法将其分为对照组(43例)和观察组(43例)。对照组患者接受动力髋螺钉(DHS)内固定治疗,观察组患者接受PFNA内固定治疗。比较两组患者的手术效果和并发症发生率,同时术后随访,比较两组患者的髋关节功能评分和炎症因子表达水平。结果:在手术时间、术中出血量、卧床时间及骨折愈合时间方面,观察组均明显低于对照组(P<0.01);观察组的总并发症发生率(4.66%)明显低于对照组(20.94%)(x^2=5.11,P=0.02);术后随访6个月,两组的Harris髋关节功能评分优良率比较无明显差异(P>0.05);手术后,血清IL-6、IL-10、TNF-α表达水平,观察组均明显低于对照组(P<0.01)。结论:PFNA治疗老年股骨转子间骨折的效果显著,手术创伤较小,术中出血量低,且并发症较低,且术后髋关节功能恢复效果较好,值得在临床推广。Objective: To study the effect of proximal femoral nail antirotation (PFNA) internal fixation in the treatment of senile intertrochanteric fracture and its effect on the function of hip joint. Methods: The subjects were 86 cases elderly intertrochanteric fractures patients in our hospital from August 2012 to May 2015, randomly divided into control group and observation group, 43 cases in each group. The control group received dynamic hip screw (DHS)internal fixation treatment, observation group patientswere treated with PFNA internal fixation.compared the operative effect and complication rate between two groups, and postoperative follow-up, compared two groups of patients with hip the score of joint function and the level of expression of inflammatory cytokines. Results: The observation group of the operation time, intraoperative blood loss, recovery time and fracture healing time was significantly lower than the control group(P<0.01); the incidence of complications in the observation group (4.66%) was significantly lower than the control group (20.94%) (x 2 =5.11, P=0.02); postoperative follow-up of 6 months, Harris the hip function of two groups was no significant difference between the score excellent rate (P>0.05). After operation, the levels of IL-6, IL-10 and TNF-α in the observation group were significantly lower than those in the control group(P<0.01). Conclusion: PFNA treatment of intertrochanteric fracture in the elderly has significant effect, less sur- gical trauma, bleeding, and fewer complications and postoperative functional restoration of hip joint The effect is good, worthy of clinical promotion.

关 键 词：PFNA DHS 老年股骨转子间骨折 髋关节功能 

分 类 号：R683.42[医药卫生—骨科学]