DHS和PFNA治疗合并帕金森病老年股骨粗隆间骨折的临床研究  

Clinical efficacy of DHS and PFNA for treatment of senile patients with intertrochanteric fracture and Parkinson's disease

作　　者：任鸿[1] 肖伟[1] 王庭刚[1] 任小宝[1] 王伟[1] 

机构地区：[1]第三军医大学西南医院急救部,重庆400038

出　　处：《局解手术学杂志》2016年第8期596-599,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市自然基金重点项目(CSTC2013jjB10005)

摘　　要：目的 探讨动力髋螺钉（DHS）和股骨近端防旋髓内钉（PFNA）治疗合并帕金森病老年股骨粗隆间骨折患者的临床疗效。方法 我院于2010年2月至2014年2月收治62例合并帕金森病的老年股骨粗隆间骨折患者,按治疗方法分为DHS组和PFNA组,每组31例,记录2组患者手术时间、X射线透视次数、术中出血量、临床骨折愈合时间、术后并发症和Harris评分,并进行统计学比较。结果 PFNA组手术时间、术中出血量、骨折愈合时间低于DHS组,差异有统计学意义（P〈0.05）,但PFNA组术中透视次数较DHS组多,差异有统计学意义（P〈0.05）。2组术后髋关节功能Harris评分结果显示,PFNA组优良率高于DHS组,且差异有统计学意义（P=0.034）。术后随访6~48个月,DHS组有4例并发症,PFNA组有1例并发症,2组比较差异无统计学意义（P〉0.05）。结论 股骨近端防旋髓内钉治疗合并帕金森病老年股骨粗隆间骨折患者具有手术时间短、出血少、愈合快等优点,值得临床推广应用。Objective To explore the clinical efficacy of dynamic hip screw（DHS） and proximal femoral nail anti-rotation （PFNA） in treatment of patients with Parkinson＇ s disease and intertrochanteric fracture. Methods A total of 62 elderly patients of Parkinson＇ s disease with femoral intertrochanteric fracture in our hospital from February 2010 to February 2014 were divided into two groups according to different internal fixations,with 31 cases in DHS group and PFNA group respectively. The operation time,X-ray fluoroscopy times,intraoperatve blood soss, the healing time of fi＇acture,postoperative complications and Harris score between two groups were recorded and compared statistically. Results The operation time,intraoperatve blood soss and the clinical healing time of PFNA group were significantly lower than those of DHS group, the differences were statistically significant （ P 〈 0.05 ）. But the times of intraoperative fluoroscopy of PFNA group was more than that of DHS group, the difference was statistically significant （ P 〈 0.05 ）. The Harris score of hip function results showed that the excellent rate of PFNA group was significantly higher than that of DHS group, the difference was statistically significant （ P = 0. 034）. All patients were fol- towed up for 6 to 48 months. There were 4 cases with complications after operation in DHS group, 1 cases of complications in PFNA group,the difference in complications was not significant （P 〉 0.05 ）. Conelusion The PFNA has the advantages of shorter operation time,less bleed- ing,faster healing time in treatment for elderly patients with Parkinson＇ s disease and intertrochanteric fracture,worth clinical promotion.

关 键 词：帕金森病 粗隆间骨折 动力髋螺钉 股骨近端防旋髓内钉 

分 类 号：R683[医药卫生—骨科学]