不同牵引方式辅助防旋股骨近端髓内钉内固定在老年股骨粗隆间骨折患者中的应用价值  

Effects of Different Traction Methods Asisted by PFNA Internal Fixation on Operative Time and Early Postoperative Trauma Stress in Elderly Patients with Intertrochanteric Fracture of Femur

作　　者：谷焕敏 梁婷婷 王桂玲 GU Huan-min;LIANG Ting-ting;WANG Gui-ling(Department of Orthopedics,Shandong Provincial Third Hospital,Jinan Shandong,250031)

机构地区：[1]山东省立第三医院骨科,山东济南250031

出　　处：《医学临床研究》2022年第2期208-211,共4页Journal of Clinical Research

摘　　要：【目的】探究不同牵引方式辅助防旋股骨近端髓内钉(PFNA)内固定在老年股骨粗隆间骨折(IFOF)患者中的应用价值。【方法】选取本院老年IFOF患者80例,按照随机数字表法分为布朗架组和牵引床组,每组40例。两组均行PFNA内固定治疗,牵引床组采取仰卧位牵引床牵引,布朗架组采取半截石位布朗架骨牵引。比较两组手术情况,术后下床活动时间,术后早期创伤应激指标[去甲肾上腺素(NE)、皮质醇(Cor)、血管紧张素Ⅱ(AngⅡ)],髋关节功能。【结果】布朗架组术前准备时间、手术时间短于牵引床组,术中失血量、术中透视次数、X线暴露次数少于牵引床组,术后下床活动时间短于牵引床组(P<0.05)。两组术后1 d、3 d血清NE、Cor、AngⅡ水平高于术前,术后1 d血清NE、Cor、AngⅡ水平高于术后3 d(P<0.05);布朗架组术后1 d、3 d血清NE、Cor、AngⅡ水平低于牵引床组(P<0.05);两组术后6个月Harris评分高于术前(P<0.05),组间比较差异无统计学意义(P>0.05)。【结论】半截石位布朗架骨牵引、仰卧位牵引床牵引辅助PFNA内固定治疗老年IFOF患者,疗效相当,但半截石位布朗架骨牵引可优化手术操作,减轻术后早期创伤应激,加快术后康复进程。【Objective】To explore the application value of different traction methods assisted by proximal femoral nail anti-rotation(PFNA)internal fixation in elderly patients with intertrochanteric fracture of femur(IFOF).【Methods】A total of 80 elderly patients with IFOF in our hospital were randomly divided into brown frame traction group and traction bed traction group,with 40 cases in each group.Both groups were treated with PFNA internal fixation.The traction bed group was treated with supine traction bed traction,and the brown frame group was treated with half stone brown frame bone traction.The operation conditions,the time of getting out of bed after operation,the indexes of early postoperative trauma stress[norepinephrine(NE),cortisol(COR),angiotensinⅡ(AngⅡ)]and hip function were compared between the two groups.【Results】The preoperative preparation time and operation time of the Brown's frame group were shorter than those of the traction bed group.The intraoperative blood loss,the number of intraoperative fluoroscopy and the number of X-ray exposures were less than that of the traction bed group.The postoperative time to get out of bed was shorter than that of the traction bed group(P<0.05);The comparison of serum NE,Cor,AngⅡgroup,time point comparison and interaction difference were statistically significant(P<0.05);Intra-group comparison:Serum NE,Cor and AngⅡat 1 and 3 days after operation were higher than those before operation,and serum NE,Cor and AngⅡat 1 day after operation were higher than 3 days after operation(P<0.05);Comparison between groups:Serum NE,Cor and AngⅡin the Brown's frame group were lower than those in the traction bed group at 1 and 3 days after surgery(P<0.05);Harris scores in the two groups were higher than before surgery at 6 months after surgery(P<0.05),There is no significant difference between groups(P>0.05).【Conclusion】Brown's skeletal traction in the semi-lithotomy position and PFNA internal fixation in the supine position traction table are effective in th

关 键 词：骨折固定术 髓内 股骨骨折/外科学 骨钉 骨牵引复位法 老年人 

分 类 号：R683.421[医药卫生—骨科学]