特立帕肽对合并骨质疏松Garden Ⅰ型股骨颈骨折非手术治疗患者的疗效观察  

Effect of teriparatide in garden I femoral neck fracture complicated with osteoporosis by conservative treatment

作　　者：宋奇志[1] 李涛[1] SONG Qi-zhi;LI Tao(Department of Orthopedics,Chonggang General Hospital,Chongqing 400080,China)

机构地区：[1]重钢总医院骨科

出　　处：《创伤外科杂志》2019年第6期449-452,共4页Journal of Traumatic Surgery

摘　　要：目的评价特立帕肽对合并骨质疏松Garden I型股骨颈骨折非手术治疗患者的疗效。方法重钢总医院骨科2014年7月-2018年7月收治合并骨质疏松的Garden I型股骨颈骨折行非手术治疗的患者58例,男性14例,女性44例;年龄56~86岁,平均64.1岁;BMI 18.2~25.4kg/m^2,平均22.7kg/m^2。两组患者均补充碳酸钙及阿法骨化醇,其中一组患者加用特立帕肽(20μg,皮下注射,1次/d)治疗,分为特立帕肽组(29例)和对照组(29例),比较两组患者治疗前后VAS评分、髋关节Harris功能评分、骨折愈合时间及骨密度。结果治疗后2周,1、3、6个月,特立帕肽组VAS评分分别为5.4±0.8、4.9±0.7、2.8±0.6、1.5±0.5,均较治疗前(7.3±1.9)明显降低(P<0.05);对照组治疗后2周,1、3、6个月VAS评分分别为7.1±1.8、5.3±0.8、3.7±0.8、2.4±0.5,与治疗前(7.3±1.8)相比,治疗后1个月VAS评分明显下降(P<0.05);治疗后2周,1、3、6个月,特立帕肽组VAS评分明显低于对照组(P<0.05);治疗后3、6个月,特立帕肽组Harris评分分别为81.5±10.5、89.6±13.1,对照组分别为71.3±9.8、83.2±12.3,特立帕肽组明显高于对照组(P<0.05);特立帕肽组平均骨折愈合时间为(8.6±0.8)周,对照组为(10.7±1.3)周,特立帕肽组明显短于对照组(P<0.05);治疗后6个月,特立帕肽组髋部及腰椎骨密度较治疗前明显增高(P<0.05);对照组骨密度与治疗前比较无明显变化(P>0.05)。结论特立帕肽快速缓解疼痛、加速骨折愈合、提高骨密度,能有效增强合并骨质疏松Garden I型股骨颈骨折非手术治疗的效果。Objective To evaluate the effect of Teriparatide in Garden I femoral neck fracture complicated with osteoporosis by conservative treatment.Methods From Jul.2014 to Jul.2018,58 cases of Garden I femoral neck fracture complicated with osteoporosis were enrolled in this study(14 males and 44 female,age 56-68 years,mean age 64.1 years,BMI 18.2-25.4 kg/m^2,mean 22.7 kg/m^2).Patients were randomly divided into Teriparatide group(29 cases) and control group(29 cases).All patients were treated with calcium carbonate and alfacalcidol.Patients in Teriparatide group were treated with Teriparatide additionally(20μg,subcutaneous injection,1 time/d).VAS scores,hip function scores(Harris),fracture healing time and bone density were compared betweenthe two groups.Results The VAS score in Teriparatide group at 2 weeks,1,3,6 month after treatment was 5.4±0.8,4.9±0.7,2.8±0.6 and 1.5±0.5,which was reduced more significantly than that before treatment.The VAS scores in control group at 2 weeks,1,3,6 month after treatment was 7.1±1.8,5.3±0.8,3.7±0.8 and 2.4±0.5,which was reduced more significantly than that before treatment except 2 weeks.Compared with control group,the VAS score was obvious lower at 2 weeks,1,3 and 6 months after treatment in Teriparatide group(P<0.05).The Harris score was 81.5±10.5 and 89.6±13.1 at 3 and 6 months after treatment in Teriparatide group,and was 71.3±9.8 and 83.2±12.3 in the control group.It was higher in Teriparatide group than in control group(P<0.05).The healing time of fracture in Teriparatide group was(8.6±0.8) weeks and it was obviously reduced compared with that(10.7±1.3) weeks in the control group(P<0.05).The bone density of femoral neck and lumbar spine in Teriparatide group was significantly increased 6 months after treatment(P<0.05),while it was not changed obviously in the control group(P>0.05).Conclusion Teriparatide could relieve pain,promote bone healing and increase the bone density and the effect of conservative treatment of Garden I femoral neck fracture complicated with

关 键 词：股骨颈骨折 骨质疏松 特立帕肽 非手术治疗 

分 类 号：R683.42[医药卫生—骨科学]