股骨近端防旋髓内钉与人工股骨头置换术治疗高龄股骨转子间骨折临床效果分析  

Clinical analysis of proximal femoral nail anti-rotation and artificial femoral head replacement in the treatment of elderly patients with intertrochanteric fractures

作　　者：孟祥启[1] 王明绪[1] 李南[1] 张鹏程[1] 

机构地区：[1]江苏省连云港市赣榆区人民医院外一科,江苏连云港222100

出　　处：《中国医药导报》2016年第30期83-86,共4页China Medical Herald

基　　金：江苏省连云港市卫生科技项目(局1426)

摘　　要：目的比较股骨近端抗旋髓内钉植入（PFNA）与人工股骨头置换术（AFHR）治疗高龄股骨转子间骨折的临床效果。方法回顾性分析2014年1月～2016年1月连云港市赣榆区人民医院收治的61例股骨转子间骨折患者，其中34例采用抗旋髓内钉植入治疗（PFNA组），27例采用人工股骨头置换术（AFHR组）。分别比较两组患者手术时间、术中出血量、围术期出血量、术后住院天数、首次下地负重时间、骨折愈合时间，并在随访时应用Harris评分评价患者髋关节功能。结果PFNA组的手术时间、术中出血量、骨折愈合时间均少于AFHR组，而围术期出血量及首次下地负重时间大于AFHR组，差异均有统计学意义（均P〈0．05）。两组住院时间、Harris评分、手术优良率比较，差异无统计学意义（P〉0．05）。结论PFNA与AFHR在临床上治疗高龄股骨转子间骨折均有较好的效果，但前者具有手术时间短、术中出血量少、骨折愈合时间短的优点。Objective To compare the clinical efficacy between the proximal femoral nail anti-rotation （PFNA） and artificial femoral head replacement （AFHR） in the treatment of elderly patients with intertrochanteric fractures. Methods 61 cases of patients with intertrochanteric fracture treated in People＇s Hospital of Ganyu District in Lianyungang City from January 2014 to January 2016 were analzyed retrospectively. 34 cases were treated with PFNA 0PFNA group）, 27 cases were treated with AFHR （AFHR group）. The operative time, intraoperative blood loss, perioperative blood loss, postoperative hospital stay, the first weight-beating ambulation time, fracture healing time were compared between the two groups. Harris score was used to evaluate the hip joint function during the follow-up time. Results The operative time, intraoperative blood loss, fracture healing time of the PFNA group were less than those of the AFHR group, while the perioperative blood loss and the first weight-bearing ambulation time were more/later than those of the AFHR group, with statistically significant differences （P 〈 0.05）. There were no statistically significant differences in hospital stays, Harris score, excellent and good rate of surgery between the two gorups （P 〉 0.05）. Conclusion PFNA and AFHR in the treatment of elderly patients with intertroehanteric fractures all have good effects, but PFNA has the advantages of shorter time of operation, less intraoperative blood loss, shorter time of fracture healing.

关 键 词：股骨近端抗旋髓内钉植入 人工股骨头置换术 股骨转子间骨折 高龄患者 Hams评分 

分 类 号：R683.420.5[医药卫生—骨科学]