高龄患者防旋近段股骨髓内钉固定术后使用降钙素的疗效观察  

Curative effect observation of PFNA combined with salmon calcitonin on unstable intertrochanteric fractures in elderly

作　　者：邹菁[1] 黄东永[1] 黄远源[1] 陈敏[1] 黄仕光[1] 王友洛[1] 

机构地区：[1]惠州市第三人民医院骨一科,广东惠州516002

出　　处：《局解手术学杂志》2016年第6期424-427,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：惠州市科技计划项目(2014802

摘　　要：目的：探讨闭合复位防旋近段股骨髓内钉内固定联合术后早期使用降钙素治疗高龄不稳定型股骨转子间骨折的疗效。方法选取90例高龄不稳定性股骨转子骨折患者，按手术方法分为 A、B、C 组（每组30例），分别给予切开复位动力髋螺钉（DHS）髓外固定、闭合复位防旋近段骨髓内钉（PFNA）内固定和闭合复位 PFNA ＋鲑鱼降钙素治疗，观察比较3组术中情况、术后恢复情况和术后并发症情况。结果在术中情况及术后恢复上 B 组比 A 组有优势；而 C 组相对于 B 组，其开始负重锻炼的时间和骨折愈合时间显著较短（t ＝4．42、5．0，P ＜0．05）；B 组术后并发症发生显著少于 A 组（χ2＝7．03，P ＜0．05）。结论闭合复位 PFNA 内固定能够以较低的术后并发症发生率、较小的手术创伤、较短的手术时间获得更好的效果，配合降钙素能够有效缩短恢复时间。Objective To observe the effect of proximal femoral nail anti-rotation（PFNA）combined with salmon calcitonin for the treatment of unstable intertrochanteric fractures in the elderly.Methods A total of 90 elderly patients with unstable intertrochanteric frac-tures were randomly divided into group A,group B and group C（30 cases in each group）.Patients in group A received open reduction with DHS,patients in group B got closed reduction with PFNA,and patients in group C received operation as group B but combined with salmon calcitonin after the operation.The intraoperative and postoperative stuation of three groups were compared.Results The intraoperative and postoperative stuation of group B was better than those of group A,the time of weight-bearing exercise and fracture healing in group C was shorter than those of group B（t =4.42;t =5.0,P 〈0.05）.The group B had a less complication than group A（χ2 =7.03,P 〈0.05）.Con-clusion The PFNA has a good restoration effect with shorter operative time,less bleeding and lower complication rate.And combined with the salmon calcitonin,which can shorten the time of recovery.

关 键 词：防旋近段股骨髓内钉 鲑鱼降钙素 不稳定型股骨粗隆间骨折 

分 类 号：R687.33[医药卫生—骨科学]