FHR、PFNA治疗伤前日常生活能力较好的高龄IFF患者效果对比研究  

A comparative study of FHR and PFNA in the treatment of elderly patients with IFF with better ability of daily life before injury

作　　者：高尚聚[1] 李文毅[1] 张隆[1] 李旭明[1] 魏景超[1] 曹参[1] GAO Shang-ju;LI Wen-yi;ZHANG Long;LI Xu-ming;WEI Jing-chao;CAO Can(Department of Orthopaedics, Hebei General Hospital, Shijiazhuang 050051, China)

机构地区：[1]河北省人民医院骨科,河北石家庄050051

出　　处：《河北医科大学学报》2021年第1期34-37,59,共5页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题计划(20150587)。

摘　　要：目的探讨人工股骨头置换术(femoral head replacement,FHR)和股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)治疗伤前日常生活能力较好的高龄股骨转子间骨折(intertrochanteric femoral fracture,IFF)患者的效果。方法选取伤前日常生活能力较好的高龄IFF患者106例,根据治疗方法不同分为FHR组51例和PFNA组55例。比较2组手术时间、围术期失血量、术后下床活动时间、住院时间、髋关节Harris评分及并发症发生情况。结果FHR组围术期失血量高于PFNA组,术后下床活动时间和住院时间均短于PFNA组,差异有统计学意义(P<0.05);2组手术时间差异无统计学意义(P>0.05)。术后12个月,2组髋关节Harris评分高于术前,FHR组髋关节Harris评分高于PFNA组,差异有统计学意义(P<0.05)。随访12个月,FHR组术后并发症总发生率低于PFNA组,差异有统计学意义(P<0.05)。结论相较于PFNA,FHR治疗伤前日常生活能力较好的高龄IFF患者可显著减少术后出血,缩短术后下床活动时间及住院时间,加快髋关节功能恢复,且并发症少。Objective To investigate the effect of artificial head replacement(FHR)and proximal femoral nail anti rotation(PFNA)in the treatment of elderly patients with intertrochanteric fracture(IFF)with good ability of daily living before injury.Methods A total of 106 elderly patients with better ADL were selected and divided into FHR group(51 cases)and PFNA group(55 cases)according to different treatment methods.The operation time,perioperative blood loss,postoperative ambulation time,hospitalization time,Harris hip score and complications were compared between two groups.Results The perioperative blood loss of FHR group was higher than that of PFNA group,postoperative ambulation time and hospitalization time were shorter than PFNA group,the difference was statistically significant(P<0.05).There was no significant difference in operation time between two groups(P>0.05).12 months after operation,Harris score of hip joint in two groups was higher than that before operation,and Harris score of hip joint in FHR group was higher than that in PFNA group,the difference was statistically significant(P<0.05).After 12 months of follow-up,the total incidence of postoperative complications in FHR group was lower than that in PFNA group(P<0.05).Conclusion Compared with PFNA,FHR can significantly reduce postoperative bleeding,shorten postoperative ambulation time and hospitalization time,accelerate hip joint function recovery,and have fewer complications.

关 键 词：股骨骨折 人工股骨头置换术 股骨近端髓内钉 

分 类 号：R683.42[医药卫生—骨科学]