防旋股骨近端髓内钉在老年髋部骨折中的应用  

Application of anti-rotation proximal femoral nail in elderly hip fracture

作　　者：周大方[1] 徐建[1] 王迎 纪兆晓 杜峥 宗浩 叶睿 王敏 ZHOU Da-fang;XU Jian;WANG Ying;JI Zhao-xiao;DU Zheng;ZONG Hao;YE Rui;WANG Min(Department of Orthopaedics,Workers′Hospital of Suqian City,Jiangsu Province,Suqian 223800,China;Department of Orthopaedics,Guangzhou Red Cross Hospital,Medical College,Ji′nan University,Guangdong Province,Guangzhou 510220,China)

机构地区：[1]江苏省宿迁市工人医院骨科,江苏宿迁223800 [2]广州市红十字会医院暨南大学医学院附属广州红十字会医院骨科,广东广州510220

出　　处：《中国当代医药》2020年第12期80-83,共4页China Modern Medicine

基　　金：广东省广州市科技计划重大项目(201607010009)。

摘　　要：目的探讨防旋股骨近端髓内钉在老年髋部骨折中的应用。方法选取2018年1月~2019年2月江苏省宿迁市工人医院和广州市红十字会医院骨科收治的90例老年髋部骨折患者作为研究对象,按照等距随机抽样法分为对照组(45例)与观察组(45例)。对照组采取股骨近端锁定钢板治疗,观察组采取防旋股骨近端髓内钉治疗。比较两组的围术期指标(手术时间、术中出血量、透视时间、血红蛋白丢失量、离床活动时间、骨折愈合时间、住院时间),记录两组的Harris评分、优良率、生存质量评分、Barthel指数、并发症总发生率。结果观察组的手术时间、离床活动时间、骨折愈合时间、住院时间短于对照组,术中出血量、血红蛋白丢失量少于对照组,透视时间长于对照组,差异有统计学意义(P<0.05);两组术前的Harris评分、生存质量评分、Barthel指数比较,差异无统计学意义(P>0.05);两组术后6个月的Harris评分、生存质量评分、Barthel指数均高于术前,差异有统计学意义(P<0.05);观察组术后6个月的Harris评分、生存质量评分、Barthel指数均高于对照组,差异有统计学意义(P<0.05);观察组的优良率高于对照组,并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论在老年髋部骨折治疗中,防旋股骨近端髓内钉更有利于手术的进行,能够促进髋关节功能恢复,可以提高生存质量及日常生活自理能力,降低并发症总发生率,值得推广应用。Objective To investigate the application of anti-rotation proximal femoral nail in elderly hip fracture.Methods A total of 90 elderly patients with hip fractures who were admitted to the Department of Orthopaedics of Suqian Workers Hospital of Jiangsu Province and Guangzhou Red Cross Hospital from January 2018 to February 2019 were selected as the study objects.They were divided into the control group(45 cases)and the observation group(45 cases)according to the isometric random sampling method.The control group was treated with proximal femoral locking plate,and the observation group was treated with anti-rotation proximal femoral nail.The perioperative indexes such as operative time,intraoperative blood loss,perspective time,hemoglobin loss,time of bed movement,fracture healing time,length of hospital stay of the two groups were compared.The Harris score,excellent and good rate,quality of life score,Barthel index and the total incidence of complications of the two groups were recorded.Results The operation time,time of bed movement,fracture healing time,and hospitalization time in the observation group were shorter than those in the control group,the intraoperative blood loss and hemoglobin loss in the observation group were less than those in the control group,and the fluoroscopy time in the observation group was longer than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences between the two groups in theHarris score,quality of life score and Barthel index before operation(P>0.05).The Harris score,quality of life score and Barthel index of the two groups at 6 months after operation were higher than those before operation,the differences were statistically significant(P<0.05).The Harris score,quality of life score and Barthel index of the observation group at 6 months after operation were higher than those of the control group,the differences were statistically significant(P<0.05).The excellent and good rate of the observation group was higher th

关 键 词：老年髋部骨折 防旋股骨近端髓内钉 股骨近端锁定钢板 HARRIS评分 BARTHEL指数 

分 类 号：R683.3[医药卫生—骨科学]