鲑鱼降钙素联合股骨近端抗旋髓内钉治疗老年患者股骨转子间不稳定型骨折的效果分析  

Observation of salmon calcitonin combined with proximal femoral nail antirotation treating unstable intertrochanteric fracture in elderly patients

作　　者：沈小辉[1] 喻伟[1] 杨菲[1] 曹洪[2] 

机构地区：[1]湖北医药学院附属东风医院创伤外科,湖北省十堰市442000 [2]湖北医药学院附属人民医院骨关节外科,湖北省十堰市442000

出　　处：《中国医药》2017年第1期122-126,共5页China Medicine

基　　金：湖北省教育厅科学技术研究项目（Q20132108）

摘　　要：目的 探讨鲑鱼降钙素联合股骨近端抗旋髓内钉治疗老年患者股骨转子间不稳定型骨折的效果。 方法 选择2012年8月至2015年2月在湖北医药学院附属东风医院诊 治的老年股骨转子间不稳定型骨折患者94例，采用随机数字表法分为观察组与对照组，各47例。所有患者都给予股骨近端抗旋髓内钉治疗，观察组在术后第1天开始应用鲑鱼降钙素 鼻喷剂（200 IU/次，1次/d，喷鼻）和碳酸钙D3片（600 mg/次，1次/d，口服）治疗，对照组仅在术后第1天使用应用碳酸钙D3片（600 mg/次，1次/d，口服）治疗；2组均持续用 药3个月。观察比较2组患者的骨折愈合时间、术后并发症发生情况、整体疗效及血清骨钙素水平。 结果 所有患者都顺利完成手术，观察组的骨折愈合时间为（11.3±1.3）周 ，明显短于对照组的（13.4±1.8）周，差异有统计学意义（P〈0.05）。观察组术后3个月并发症发生率低于对照组，差异有统计学意义［4.3%（2/47）比23.4%（11/47）］（P〈0.05） 。观察组与对照组术后3个月的Harris 评分优良率分别为95.7%（45/47）和78.7%（37/47），观察组明显高于对照组，差异有统计学意义（P〈0.05）。观察组与对照组术后3个月的血 清骨钙素含量分别为（9.2±1.2）μg/L和（8.1±1.5）μg/L，均明显高于术后1 d的（7.3±1.0）μg/L和（7.4±1.1）μg/L，差异有统计学意义（P〈0.05）；术后3个月组间比较 差异也有统计学意义（P〈0.05）。 结论 鲑鱼降钙素联合股骨近端抗旋髓内钉治疗老年股骨转子间不稳定型骨折能调节血钙代谢，促进骨折愈合，减少术后并发症的发生，有利 于髋关节功能的恢复。Objective To observe the curative effect of salmon calcitonin combined with proximal femoral nail antirotation（PFNA） on unstable intertrochanteric fracture in elderly patients. Methods Totally 94 elderly patients with unstable intertrochanteric fracture from August 2012 to February 2015 Dongfeng Hospital Affiliated to Hubei University of Medicine were randomly divided into observation group and control group, with 47 cases in each group. All patients had PFNA operation, the observation group were treated with salmon calcitonin and Calcium carbonate and Vitamin D3 tablet after operation, the control group were treated treated with Calcium carbonate and Vitamin D3 tablet alone. After 3 months of treatment, length of fracture healing, postoperative complication incidence, overall curative effect and serum osteocalcin level were analyzed. Results All patients were successfully operated. In observation group, length of fracture healing and incidence of postoperative complications were significantly lower than those in control group [（11.3±1.3）weeks vs （13.4±1.8）weeks, 4.3%（2/47） vs 23.4%（11/47）]（P〈0.05）. Three months after operation, Harris score excellent rate in observation group was significantly higher than that in control group[95.7%（45/47） vs 78.7%（37/47）]（P〈0.05）; serum osteocalcin levels were significantly higher than those 1 d after operation in both groups[observation group： （9.2±1.2）μg/L vs （7.3±1.0）μg/L, control group： （8.1±1.5） μg/L vs （7.4±1.1）μg/L]（P〈0.05）, and the difference of serum osteocalcin level between groups were significant（P〈0.05）. Conclusions almon calcitonin combined with PFNA can regulate calcium metabolism, promote fracture healing and reduce postoperative complications in the treatment of unstable intertrochanteric fracture in elderly patients.

关 键 词：股骨转子间骨折 鲑鱼降钙素 股骨近端抗旋髓内钉 骨钙素 

分 类 号：R683.3[医药卫生—骨科学]