改良术式配合中药治疗中青年股骨颈骨折中期疗效评价  

Intermediate Evaluation of Clinical Efficacy of Improved Surgical Method Combined with Chinese Medicine for Treatment of Young and Middle-aged Femoral Neck Fractures

作　　者：周驰[1] 何伟[2] 王海彬[2] 庞智晖[2] 田天照 陈群群[1] 

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院髋关节中心,广东广州510405 [3]广州市中医院,广东广州510400

出　　处：《广州中医药大学学报》2014年第5期720-727,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(编号:81373655);国家自然科学基金资助项目(编号:81173284);广东省优秀博士论文培育资助项目(编号:YB201302)

摘　　要：【目的】探讨空心钉联合同种异体腓骨内固定（以下称：改良术式）配合活血化瘀中药治疗对中青年新鲜股骨颈骨折患者的中期生活质量的影响。【方法】回顾性分析80例在广州中医药大学第一附属医院关节骨科行空心钉联合同种异体腓骨内固定术的中青年新鲜股骨颈骨折（改良术式组）患者及50例单纯行空心钉内固定术（对照组）患者,术后均配合口服活血化瘀中药,末次随访评价疗效,包括Harris评分、SF-36评分及影像学评价等。【结果】改良术式组80例（80髋）初步随访48~84个月,平均（62.68±12.43）个月,优良率达93.75%,其Harris评分、SF-36评分均达到优良标准;改良术式组的生活质量在躯体功能（PF）、躯体疼痛（BP）、心理健康（MH）、活力（VT）、整体健康（GH）评分方面均比对照组高,差异均有统计学意义（P〈0.05或P〈0.01）;改良术式组的Harris评分在疼痛、功能及生活能力以及关节活动度方面均优于对照组,差异均有统计学意义（P〈0.05或P〈0.01）。【结论】空心钉联合同种异体腓骨内固定配合活血化瘀中药治疗中青年股骨颈骨折中期疗效良好,股骨头坏死后塌陷率较低,关节置换少,患者的生活质量、Harris评分及影像学指标均较单纯空心钉固定好。Objective To explore the effect of improved surgical method of intramedullary fibular allograft together with cannulated screw fixation combined with blood-activating and stasis-resolving Chinese medicine on the quality of life （QOL） of young and middle-aged fresh femoral neck fractures at intermediate stage. Methods A retrospective analysis was carried out in the articular orthopedics department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The study involved 80 cases of young and middle-aged fresh femoral neck fractures receiving intramedullary fibular allograft together with cannulated screw fixation, and 50 qualified cases receiving cannulated screw fixation alone （control group） . After the operation, all of the patients were given oral use of blood-activating and stasis-resolving Chinese medicine. After the last follow-up, Harris hip scoring, SF-36 scoring and radiographic evaluation were performed for the evaluation of clinical efficacy. Results The clinical application of intramedullary fibular allograft together with cannulated screw fixation combined with Chinese medicine was fulfilled in 80 hips of 80 cases. The follow-up period ranged from 48 to 84 months, averaging 62.68 ＋- 12.43 months. The improved surgical method group had an excellent and good rate of 93.75%, presented excellent-grade Harris scores and SF-36 scores, and had higher QOL scores than the control group （P〈O.05） . After treatment, the two groups had statistically significant differences in the scores of SF-36 items of physical function （PF）, bodily pain （BP）, mental health （MH）, vitality （VT）, and general health （GH） （P〈0.05 or P〈0.01）, and also had significant differences in Harris scoring of pain, function and daily activities as well as the joint range-of-motion （P〈0.05 or P〈0.01） . Conclusion The improved surgical method of intramedullary fibular allograft together with cannulated screw fixation combined with blood-activating and stasis-resolving Ch

关 键 词：股骨颈骨折 空心钉 同种异体腓骨 内固定器 生活质量 中青年 

分 类 号：R683.42[医药卫生—骨科学]