PFNA联合锁定重建钢板治疗股骨粗隆间骨折的应用价值研究  

Application value of PFNA combined with locking reconstruction plate in the treatment of intertrochanteric fracture of femur

作　　者：程爱民 单清洁 郝光亮 尹君 CHENG Ai-min;SHAN Qing-jie;HAO Guang-liang;YIN Jun(Department of Orthopedics,Traditional Chinese Medicine Hospital of Taihe County Affiliated to Anhui University of Chinese Medicine,Fuyang 236600,Anhui,China)

机构地区：[1]安徽中医药大学附属太和中医院骨一科,安徽阜阳236600

出　　处：《川北医学院学报》2021年第7期890-893,共4页Journal of North Sichuan Medical College

基　　金：安徽中医药大学科研基金项目(2020thzy019)。

摘　　要：目的:探讨股骨近端抗旋髓内钉(PFNA)联合锁定重建钢板治疗股骨粗隆间骨折的应用价值。方法:选取80例股骨粗隆间骨折患者为研究对象,根据治疗方式不同分为观察组和对照组,每组各40例。观察组采用PFNA联合锁定重建钢板治疗;对照组采用PFNA治疗。比较两组患者手术时间及术中出血量、负重及骨折愈合时间、关节功能恢复情况、血清炎性因子白细胞介素1(IL-1)、白细胞介素6(IL-6)、α肿瘤坏死因子(TNF-α)、和氧化应激因子去甲肾上腺素(NE)、丙二醛和3-硝基络氨酸修饰蛋白(3-NT)水平及术后不良事件发生情况。结果:观察组手术时间及术中出血量高于对照组(P<0.05);负重时间和骨折愈合时间短于对照组(P<0.05);术后3个月及6个月,观察组疼痛、功能、行走能力、活动度和畸形评分高于对照组(P<0.05)。术后3周,两组患者血清IL-1、IL-6、TNF-α、NE、丙二醛和3-NT水平均降低(P<0.05),且观察组IL-1、IL-6、TNF-α水平低于对照组(P<0.05)。观察组患者术后不良事件总发生率低于对照组(P<0.05)。结论:PFNA联合锁定重建钢板治疗能更快促进骨折愈合,改善关节功能,且能有效减轻炎症反应,降低不良事件的发生率,值得临床推广。Objective:To investigate the application value of PFNA combined with locked reconstruction plate in the treatment of intertrochanteric fracture of femur.Methods:80 patients with intertrochanteric fracture were divided into observation group(PFNA combined with locking reconstruction plate,n=40)and control group(PFNA,n=40)according to different treatment regimen.The operative time,intraoperative blood loss,loading time and fracture healing time,recovery of joint function,serum interleukin 1(IL-1),interleukin 6(IL-6),tumor necrosis factorα(TNF-α)and oxidative stress indexes of serum noradrenaline(NE),malondialdehyde(MDA)and 3-nitrotyrosine modified protein(3-NT)were compared between the two groups.The incidence of postoperative adverse events in the two groups was recorded.Results:The operative time and intraoperative blood loss in the observation group were higher than those in the control group(P<0.05).The loading time and fracture healing time in the observation group were shorter than those in the control group(P<0.05).At 3 and 6 months after operation,the pain score,functional score,walking ability score,activity score and deformity score in the observation group were significantly higher than those in the control group at the corresponding time(P<0.05).3 weeks after operation,the serum levels of IL-1,IL-6 and TNF-α,NE,MDA and 3-NT in the two groups were significantly decreased(P<0.05).And the levels of IL-1,IL-6 and TNF-αin the the observation group was significantly lower than those in the control group(P<0.05).The total incidence of postoperative adverse events in the observation group was lower than that in the control group(P<0.05).Conclusion:PFNA combined with locked reconstruction plate can accelerate fracture healing,improve joint function,effectively reduce inflammatory reaction and reduce the incidence of adverse events,which is worthy of clinical promotion.

关 键 词：股骨粗隆间骨折 股骨近端抗旋转髓内钉 锁定重建钢板 并发症 

分 类 号：R683[医药卫生—骨科学]