股骨近端防旋髓内钉与骨水泥柄人工股骨头置换治疗老年人股骨粗隆间骨折的疗效比较  

Comparison of the effect of proximal femoral anti-rotation nail and artificial femoral head replacement with bone cement in the treatment of intertrochanteric fracture of femur in elderly patients

作　　者：曹江龙[1] 李旭晨[1] 马慧勇[1] Cao Jianglong Li Xuchen Ma Huiyong(Department of Orthopedics, Heft Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi 046000, Chin)

机构地区：[1]长治医学院附属和济医院骨科,山西省长治046000

出　　处：《中国基层医药》2017年第13期2014-2017,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 比较股骨近端防旋髓内钉与骨水泥柄人工股骨头置换治疗老年人股骨粗隆间骨折的疗效.方法 选取70例老年股骨粗隆间骨折患者为研究对象,采用随机数字表法将其分成观察组和对照组,每组35例.观察组实施股骨近端防旋髓内钉固定术治疗,对照组则实施骨水泥柄人工股骨头置换术治疗,观察并对比两组患者的临床疗效.结果 观察组手术时间、术中出血量分别为（52.63±13.72）min、（115.26±35.17）mL,对照组分别为（86.69±21.15）min、（328.72±47.62）mL,观察组均明显优于对照组（t=3.98、9.86,均P〈0.05）;观察组术后开始站立、行走时间分别为（12.36±3.61）d、（17.51±3.60）d,对照组分别为（9.42±3.18）d、（15.18±3.55）d,对照组均短于观察组,但差异均无统计学意义（t=1.36、1.08,均P〉0.05）;两组术后30个月髋关节Harris评分差异无统计学意义（t=0.18,P〉0.05）,对照组术后18、24个月髋关节Harris评分均明显高于观察组,差异均有统计学意义（t=9.04、3.75,均P〈0.05）.结论 对于老年股骨粗隆间骨折患者的临床手术治疗,股骨近端防旋髓内钉固定术手术时间短,患者受到的创伤较小;但应用骨水泥柄人工股骨头置换术有利于患者髋关节早期功能的恢复.Objective To compare the efficacy of proximal femoral anti-rotation nail and artificial femoral head replacement with bone cement in the treatment of intertrochanteric fracture of femur in elderly patients.Methods70 elderly patients with intertrochanteric fracture of femur were selected as the research subjects,and they were randomly divided into the observation group and the control group according to the digital table,35 cases in each group.The observation group was treated with proximal femoral anti-rotation nail,the control group was treated with artificial femoral head replacement with bone cement.The clinical efficacy of the two groups was observed and compared.Results The operation time,intraoperative bleeding volume of the observation group were （52.63±13.72）min,（115.26±35.17）mL,respectively,which were significantly better than those of the control group[（86.69±21.15）min,（328.72±47.62）mL,t=3.98,9.86,all P〈0.05].The time of standing and walking after operation in the observation group were （12.36±3.61）d,（17.51±3.60）d,which were longer than those of the control group[（9.42±3.18）d,（15.18±3.55）d],but the differences were not statistically significant（t=1.36,1.08,all P〉0.05）.There was no significant difference in the Harris hip score 30 months after operation between the two groups（t=0.18,P〉0.05）,while the Harris hip score of the observation group after 6 and 12 months were higher than those of the control group,the differences were statistically significant（t=9.04,3.75,all P〈0.05）.ConclusionCompared with artificial femoral head replacement with bone cement,proximal femoral anti-rotation nail for elderly patients with intertrochanteric fracture of femur has more significant effect,it is worthy of clinical promotion.

关 键 词：股骨骨折 骨折固定术 内 骨固定钢丝 关节成形术 置换 髋 老年人 

分 类 号：R687.3[医药卫生—骨科学]