Gamma钉、DHS和PFNA治疗骨质疏松性股骨粗隆间骨折的疗效探讨  

Efficacy of Gamma Nail, DHS and PFNA in the Treatment of Osteoporotic Intertrochanteric Fracture

作　　者：于桂生[1] 

机构地区：[1]山东省菏泽市立医院骨创外科,山东菏泽274000

出　　处：《中外医疗》2016年第4期1-3,共3页China & Foreign Medical Treatment

摘　　要：目的探讨Gamma钉、DHS和PFNA治疗骨质疏松性股骨粗隆间骨折的疗效。方法整群选择2011年5月—2014年5月期间该院收治的114例骨质疏松性股骨粗隆间骨折作为研究对象,根据治疗方法将其分为Gamma钉组38例、DHS组38例和PFNA组38例。观察对比三组患者手术情况、临床疗效及并发症情况。结果 PFNA组术中出血量及手术时间分别为(166.58±26.55)m L、(66.28±10.50)h均低于Gamma钉组的(206.52±25.33)m L、(84.33±10.22)h与DHS组的(428.52±26.32)m L、(102.35±10.25)h(P<0.05)。Gamma钉组、DHS组及PFNA组治疗的优良率分别为86.85%、92.11%、92.11%,三组患者治疗的优良率对比差异均无统计学意义(P>0.05)。PFNA组并发症发生率为2.63%,显著低于Gamma钉组的21.05%与DHS组的23.68%(P<0.05)。结论 Gamma钉、DHS和PFNA治疗骨质疏松性股骨粗隆间骨折疗效相当,但PFNA的术中出血量及手术时间较短,且并发症少,适于临床推广。Objective To investigate the effect of Gamma nail, DHS and PFNA in the treatment of osteoporotic intertrochanteric fracture. Methods 114 cases with osteoporotic intertrochanteric fracture admitted in our hospital from May2011 to May 2014 were selected as the subjects and divided into Gamma nail group, DHS group and PFNA group with 38 cases in each in accordance with the treatment method. The surgery status, clinical efficacy and incidence of complications of the 3 groups were observed and compared. Results The intraoperative blood loss was（166.58±26.55） m L,（206.52±25.33）m L, and（428.52 ±26.32） m L, respectively in the PFNA group, Gamma nail group, and DHS group, the PFNA group had much less intraoperative blood loss than the Gamma nail group and the DHS group（P〈0.05）. The duration of procedure was（66.28±10.50）h,（84.33±10.22）h and（102.35±10.25）h in the PFNA group, Gamma nail group and DHS group, respectively,which showed that the PFNA group had much shorter duration of procedure than the Gamma nail group and the DHS group（P〈0.05）. The excellent and good rate was 86.85%, 92.11%, 92.11%, respectively in the Gamma nail group, DHS group and PFNA group, with no statistically significant difference between the groups（P〈0.05）. The incidence of complications was2.63%, 21.05%, 23.68% respectively in the PFNA group, Gamma nail group and DHS group, which showed that the PFNA group had much lower incidence of complications than the Gamma nail group and DHS group（P〈0.05）. Conclusion The effect of Gamma nail, DHS or PFNA in the treatment of osteoporotic intertrochanteric fracture is similar, but PFNA has shorter duration of procedure and lower incidence of complications, so it is suitable for clinical practice.

关 键 词：GAMMA钉 DHS PFNA 骨质疏松 股骨粗隆间骨折 

分 类 号：R5[医药卫生—内科学]