小切口股骨近端防旋髓内钉内固定术治疗股骨粗隆间骨折的效果  

Efficacy of small incision proximal antirotation intramedullary nailing in treatment of intertrochanteric fractures of femur

作　　者：白伟 王建建 王振昊[1] BAI Wei;WANG jian-jian;WANG zhen-hao(Trauma Ward,No.1 Trauma Ward,Department of Orthopedics,988 Hospital,Joint Logistics Support Force of Chinese People's Liberation Army,Zhengzhou 450000,Henan,China)

机构地区：[1]中国人民解放军联勤保障部队第988医院骨科一病区创伤病区,河南郑州450000

出　　处：《中国校医》2021年第10期776-778,782,共4页Chinese Journal of School Doctor

摘　　要：目的探讨小切口股骨近端防旋髓内钉内固定术和术治疗股骨粗隆间骨折疗效及术后安全性。方法选取2015年6月—2019年10月本院收治的股骨粗隆间骨折患者150例,根据随机数表法分为小切口组(75例)和对照组(75例),对照组患者使用股骨近端重建钉内固定术治疗,小切口组使用小切口股骨近端防旋髓内钉内固定术治疗,比较两组患者临床疗效,观察两组患者手术时间、术中出血量、下床活动时间和住院时间,并对两组患者VAS评分、Harris评分和并发症发生率进行比较。结果小切口组治疗有效率为96.00%,高于对照组的90.67%,(χ^(2)=8.917,P=0.012)。小切口组手术时间为(42.29±5.46)min、术中出血量为(87.49±9.9)mL、下床活动时间为(5.74±1.01)d、住院时间为(10.17±2.25)d,均少于对照组的(61.09±8.43)min、(153.82±16.82)mL、(10.34±2.14)d、(17.58±3.38)d,(t=18.53、33.64、19.24、18.07,P值均<0.01)。两组患者术前VAS评分和Harris评分差异无统计学意义(P值均>0.05),治疗后小切口组VAS评分为(2.42±0.74),低于对照组的(4.68±0.98),Harris评分为(86.34±12.11),高于对照组的(78.51±10.69),差异有统计学意义(P值均<0.05)。小切口组患者不良反应发生率为4.00%,低于对照组的14.67%,(χ^(2)=5.042,P=0.025)。结论小切口股骨近端防旋髓内钉内固定术治疗股骨粗隆间骨折疗效显著,可明显减少患者术中出血量,缩短患者住院时间,改善髋关节功能,且并发症较少,具有较高安全性,值得临床进一步研究。Objective To investigate the efficacy and postoperative safety of small incision proximal femoral nail internal fixation in the treatment of intertrochanteric fracture.Methods From June 2015 to October 2019,in our hospital,150 patients with intertrochanteric fracture were selected as the research objects,and according to the stochastic indicator method,they were divided into a small incision group(75 cases) and a control group(75 cases).The patients in the control group received the proximal femoral reconstruction nail fixation treatment,and the patients in the small incision group were given the small incision proximal femur intramedullary nail fixation treatment.The clinical curative effects,operation time,intraoperative blood loss,bed activity time and hospital stay,the VAS scores,Harris scores,and the incidence of complications of the two groups were observed and compared between the two groups.Results The effective rate of the small incision group was 96.00%,higher than that of the control group(90.67%),and the difference was statistically significant(χ^(2)=8.917,P=0.012).In the small incision group,the operative time [(42.29±5.46) min)],intraoperative blood loss [(87.49±9.91) mL],the time of getting out of bed [(5.74±1.01) d] and the hospitalization time [(10.17±2.25) d] were all lower than those in the control group [(61.09±8.43) min,(153.82±16.82) mL,(10.34±2.14) d,(17.58±3.38) d],and the differences were statistically significant(t=18.53,33.64,19.24,18.07,all P <0.01).There were no significant differences in the average preoperative VAS score and Harris score between the two groups(both P> 0.05).After the treatment,the average VAS score of the small incision group(2.42±0.74)was lower than that of the control group(4.68±0.98),and the Harris score of the small incision group(86.34±12.11)was higher than that of the control group(78.51±10.69),and the differences were statistically significant(both P <0.05).The incidence of adverse reactions in the small incision group was 4.00%,which was lower t

关 键 词：小切口股骨近端防旋髓内钉内固定术 股骨近端重建钉内固定术 股骨粗隆间骨折 安全性 临床疗效 

分 类 号：R683.42[医药卫生—骨科学]