仰卧和侧卧手术体位股骨近端防旋髓内钉治疗股骨转子间骨折疗效的对比研究  

Comparative study on the effect of proximal femoral nail antirotation in the treatment of intertrochanteric fracture in supine and lateral position

作　　者：李明 李强[1] 段芳芳 LI Ming;LI Qiang;DUAN Fang-fang(Department of Osteology,Suzhou First People's Hospital,Suzhou Anhui 234000)

机构地区：[1]宿州市第一人民医院骨一科,安徽宿州234000

出　　处：《临床和实验医学杂志》2020年第18期1967-1971,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省卫生厅科研项目(编号:2017LB0019)。

摘　　要：目的对比观察仰卧和侧卧手术体位对股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的临床疗效。方法选取2017年8月至2018年8月宿州市第一人民医院收治的82例股骨转子间骨折患者,采用数字奇偶法将其分为对照组和观察组,每组各41例。观察组患者采取侧卧位治疗,对照组患者采取仰卧位治疗。比较两组患者手术情况、术后的并发症发生率。术后以门诊复查的方式随访1年,观察两组患者术后骨折恢复情况。结果观察组手术时间、术中出血量均少于对照组(P<0.05);术后两组患者均以门诊复查的方式获得随访,无失访者;观察组Harris功能评分、生活质量评分均高于对照组(P<0.05);两组患者切口长度、下地活动时间、住院时间、骨折愈合时间、骨折愈合质量以及术后并发症发生率比较差异无统计学意义(P>0.05)。结论侧卧位PNFA内固定治疗股骨转子间骨折可缩短手术时间,减少术中出血量,推荐临床应用。Objective To investigate the effect of supine position and lateral position on the treatment of intertrochanteric fracture of femur with proximal femoral nail anti-rotation(PFNA).Methods 82 patients with intertrochanteric fracture in Suzhou First People's Hospital from August 2017 to August 2018 were selected and divided into control group and observation group by digital parity method,with 41 cases in each group.Patients in the observation group were treated with lateral decubitus position,while patients in the control group were treated with supine position.The operation conditions and postoperative complications were compared between the two groups.The patients were followed up for 1 year by outpatient reexamination,and the recovery of fracture in the two groups was observed.Results The operation time and blood loss in the observation group were less than those in the control group(P<0.05);After the operation,the patients in both groups were followed up by the way of outpatient reexamination,and no one lost the follow-up;The Harris function score and quality of life score in the observation group were higher than those in the control group(P<0.05);There was no significant difference in incision length,ambulation time,hospital stay,fracture healing time,fracture healing quality and postoperative complications between the two groups(P>0.05).Conclusion PNFA internal fixation in lateral decubitus position can shorten the operation time and reduce the amount of bleeding during the operation,which is recommended for clinical application.

关 键 词：股骨转子间骨折 股骨近端防旋髓内钉 仰卧位 侧卧位 疗效 

分 类 号：R687.3[医药卫生—骨科学]