人工股骨头置换与PFNA内固定术治疗老年股骨粗隆间骨折的临床应用效果分析  

Clinical Application Effect of Artificial Femoral Head Replacement and PFNA Internal Fixation for Treatment of Intertrochanteric Fractures in the Elderly

作　　者：肖永庆[1] 陈志平[1] 张建军[1] 杜亮 XIAO Yong-qing;CHEN Zhi-ping;ZHANG Jian-jun;DU Liang(Department of Orthopaedics,People's Hospital of Huaying City,Huaying,Sichuan Province,638600 China)

机构地区：[1]四川省华蓥市人民医院骨科,四川华蓥638600

出　　处：《中外医疗》2018年第23期65-67,共3页China & Foreign Medical Treatment

摘　　要：目的探析人工股骨头置换与PFNA内固定术治疗老年股骨粗隆间骨折的临床应用效果。方法便利选取该院2013年1月—2018年1月收治的75岁以上的老年股骨粗隆间骨折100例,随机分为两组,各50例。采取内固定术治疗对照组,采取人工股骨头置换术治疗观察组。比较两组临床效果。结果观察组住院天数、手术时间、术后首次下床时间等较对照组显著较短,组间差异有统计学意义(P<0.05);术后血红蛋白(13%)较对照组(17%)降低较(χ~2=1.627 5,P=0.042);且满意度(95%)较对照组(85%)明显提高(χ~2=5.555 6,P=0.018)。观察组髋关节改善优良率90.0%(45/50)较对照组80.0%(40/50)显著较高,组间差异有统计学意义(χ~2=3.921 6,P=0.047)。结论采用人工股骨头置换术治疗75岁以上老年股骨粗隆间骨折患者的效果明显优于PFNA内固定术,且前者能显著改善患者髋关节功能,并加速其病情恢复,值得应用推广。Objective To explore the clinical effect of artificial femoral head replacement and PFNA internal fixation in the treatment of intertrochanteric fractures in the elderly.Methods A total of 100 cases of intertrochanteric femoral fractures aged over 75 years old who were admitted to the hospital between January 2013 and January 2018 were conveniently selected and randomly divided into two groups,50 cases each.The internal fixation was used to treat the control group and artificial femoral head replacement was used to treat the observation group.Compare the clinical effects of the two groups.Results Compared with the control group,the number of hospitalization days,operation time,and first-time bed rest in the observation group were significantly shorter,and the difference between the two groups was(P<0.05);the postoperative hemoglobin(13%)was lower than the control group(17%)(χ2=1.627 5,P=0.042);and satisfaction(95%)was significantly higher than the control group(85%)(χ2=5.555 6,P=0.018).The improvement rate of 90.0%(45/50)in hips in the observation group was significantly higher than that in the control group 80.0%(40/50),and the difference between the groups was statistically significant(χ2=3.921 6,P=0.047).Conclusion The use of artificial femoral head replacement for the treatment of femoral intertrochanteric fractures in patients older than 75 years is significantly better than PFNA internal fixation.The former can significantly improve hip joint function and accelerate the recovery of the disease,which is worthy of application and promotion.

关 键 词：粗隆间骨折 人工股骨头置换术 PFNA内固定术 

分 类 号：R687[医药卫生—骨科学]