股骨近端防旋髓内钉与解剖型锁定钢板治疗股骨粗隆间骨折的临床效果  

Clinical effect of anti-rotation intramedullary nail and anatomical locking plate on the treatment of femoral intertrochanteric fractures

作　　者：陈凤华[1] 陆晨星 CHEN Feng-hua;LU Chen-xing(Department of Orthopedics,Taizhou Hospital of Traditional Chinese Medicine,Jiangsu Province,Taizhou,225300,China)

机构地区：[1]江苏省泰州市中医院骨科,江苏泰州225300

出　　处：《中国当代医药》2021年第33期97-100,共4页China Modern Medicine

摘　　要：目的探讨股骨近端防旋髓内钉与解剖型锁定钢板治疗股骨粗隆间骨折的临床效果。方法选取2015年1月至2020年6月泰州市中医院收治的65例股骨粗隆间骨折患者为研究对象,采用随机数字表法分为观察组(n=33)与对照组(n=32)。观察组采用防旋型股骨近端髓内钉(PFNA)技术方案,对照组采用解剖型锁定钢板技术方案。比较两组的手术指标(手术时间、术中出血量、离床负重时间、住院天数)、手术前后骨代谢指标[I型胶原羧基末端肽(CTX)、Ⅰ型前胶原氨基端前肽(PINP)]、手术前后炎症因子水平[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、手术优良率和并发症总发生率。结果观察组的手术时间、离床负重时间、住院天数短于对照组,观察组的术中出血量少于对照组,差异有统计学意义(P<0.05)。术前,两组CTX、PINP比较,差异无统计学意义(P>0.05);术后,两组CTX低于本组术前,PINP高于本组术前,且观察组CTX低于同期对照组,PINP高于同期对照组,差异有统计学意义(P<0.05)。术前,两组IL-6、TNF-α比较,差异无统计学意义(P>0.05);术后,两组IL-6、TNF-α高于本组术前,但观察组IL-6、TNF-α低于同期对照组,差异有统计学意义(P<0.05)。两组手术优良率比较,差异无统计学意义(P>0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论股骨粗隆间骨折应用PFNA技术展开治疗,相较解剖型锁定钢板技术,可改善手术质量及骨代谢水平,降低炎症程度,增强手术效果,防范手术并发症。Objective To investigate the clinical effect of proximal femoral anti-rotation intramedullary nail and anatomical locking plate in the treatment of femoral intertrochanteric fractures.Methods A total of 65 patients with intertrochanteric fractures of the femur admitted to Taizhou Hospital of Traditional Chinese Medicine from January 2015 to June 2020 were selected as the research objects.They were divided into the observation group(n=33)and the control group(n=32)according to the random number table method.The observation group used the proximal femoral nail antirotation(PFNA)technical plan,and the control group used the anatomical locking plate technical plan.The surgical indicators(operation time,intraoperative bleeding,time of load departure,days of hospitalization),bone metabolism indicators before and after surgery(β-carboxyterminal telopeptide oftype I collagen(CTX),procollagen I N-terminal propeptide(PINP]),levels of inflammatory factors before and after surgery(Interleukin-6[IL-6],tumor necrosis factor-α[TNF-α]),the excellent and good rate of surgery,and the total incidence of complications were compared between the two groups.Results The operation time,time of load departure,days of hospitalization of the observation group were shorter than those of the control group,and the intraoperative bleeding of the observation group was less than that of the control group,with statistically significant differences(P<0.05).Before surgery,there were no statistically significant differences of CTX,PINP between the two groups(P>0.05).After surgery,the CTX of the two groups was lower than that before surgery,the PINP of the two groups was higher than that before surgery,and the CTX of the observation groups was lower than that of the control group in the same period,the PINP of the observation groups was higher than that of the control group in the same period,with statistically significant differences(P<0.05).Before surgery,there were no statistically significant differences of IL-6,TNF-αbetween the two groups(P>0

关 键 词：股骨粗隆间骨折 防旋型股骨近端髓内钉 解剖型锁定钢板 骨代谢指标 炎症因子 

分 类 号：R687.3[医药卫生—骨科学]