不稳定型股骨粗隆间骨折应用不同方法治疗的疗效探讨  

Treatment of Unstable Intertrochanteric Fractures with Different Methods

作　　者：王磊[1] 汤健[1] 李光宇[1] 周剑[1] WANG Lei;TANG Jian;LI Guangyu;ZHOU Jian(Department of Orthopedics,First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230032,China)

机构地区：[1]安徽医科大学第一附属医院骨外科,安徽合肥230032

出　　处：《中国继续医学教育》2018年第9期77-79,共3页China Continuing Medical Education

基　　金：安徽省科技攻关计划项目(1301042096)

摘　　要：目的探讨老年不稳定型股骨粗隆间骨折应用股骨近端防旋髓内钉(PFNA)和人工股骨头置换术治疗的临床效果。方法选取2016年7月-2017年7月我院收治的老年不稳定型股骨粗隆间骨折患者共76例,随机数字抽签法将其分为对照组和观察组各38例。对照组实施人工股骨头置换术,观察组实施股骨近端防旋髓内钉固定治疗。比较患者手术时间、术中出血量,统计患者Harris髋关节功能评分、预后生活质量QLQ-C30评分及术后并发症发生率。结果观察组患者的手术时间、术中出血量比较无差异(P>0.05);观察组患者的Harris评分和QLQ-C30评分均与对照组比较无差异(P>0.05),观察组患者术后并发症与对照组比较无差异(P>0.05)。结论股骨近端防旋髓内钉及人工股骨头置换术治疗老年不稳定型股骨粗隆间骨折,疗效显著,手术出血量少,患者术后并发症少,整体髋关节功能和生活质量评分均较高,值得临床推广,临床在推广中,应该结合患者身体情况和经济条件,合理选择手术方案,既要保证疗效,也要考虑患者负担。Objective To investigate the clinical effect of proximal femoral nail anti rotation(PFNA)and artificial femoral head replacement in the treatment of unstable intertrochanteric fractures in the elderly.Methods From July 2016 to July 2017,76 elderly patients with unstable intertrochanteric fractures were randomly divided into the control group and the observation group,38 cases in each group.The control group was treated with artificial femoral head replacement,and the observation group was treated with proximal femoral nail fixation.The patients'operation time,the amount of intraoperative bleeding,the Harris hip function score,the prognosis of life quality QLQ-C30 score and the incidence of postoperative complications were compared.Results The operative time,bleeding volume in patients had no difference between two groups(P>0.05);The observation group of patients with Harris score and QLQ-C30 score were compared with the control group had no significant difference(P>0.05),postoperative complications in the observation group compared with the control group had no significant difference(P>0.05).Conclusion Proximal femoral intramedullary nail and artificial femoral head replacement in treatment of elderly patients with unstable intertrochanteric fractures,surgical curative effect,less bleeding,less postoperative complications,hip function and overall quality of life scores are high,it is worthy of clinical promotion,in clinical promotion,should be combined with the health and economic conditions,a reasonable choice of surgical approach,both to ensure the curative effect,also want to consider the burden of patients.

关 键 词：股骨近端防旋髓内钉(PFNA) 老年不稳定型股骨粗隆间骨折 人工股骨头置换术 髋关节功能 生活质量 疗效 

分 类 号：R683.42[医药卫生—骨科学]