自制进针导向器在A2型老年股骨粗隆区骨折防旋股骨近端髓内钉微创手术中的应用  

Application of self-made needle guide in the treatment of type A2 femoral trochanteric fractures in the elderly patients with proximal femoral nail antirotating microtraumatic operation

作　　者：程后庆[1] 李景光[1] 张军[1] 吴德林 黄宇 CHENG Houqing;LI Jingguan;ZHANG Jun;WU Delin;HUANG Yu(Department of Orthopedics,Wuhu Hospital of Traditional Chinese Medicine,Anhui Province,Wuhu 241000,China)

机构地区：[1]安徽省芜湖市中医医院骨科,安徽芜湖241000

出　　处：《中国医药导报》2022年第18期15-19,共5页China Medical Herald

基　　金：安徽省教育厅安徽省高校自然科学研究项目(重点)(KJ2019A1088);安徽中医药高等专科学校校级自然科学研究重点项目(ZRKXZ2020011)。

摘　　要：目的评价自制进针导向器在A2型老年股骨粗隆区骨折防旋股骨近端髓内钉(PFNA)微创手术中的应用效果。方法选择安徽省芜湖市中医医院(以下简称“我院”)2019年2月至2020年6月收治的A2型老年股骨粗隆区骨折患者62例,通过计算机随机法将其分为观察组(31例)和对照组(31例)。观察组行PFNA微创手术,术中应用我院自制的PFNA进针导向器。对照组行常规PFNA手术。比较两组手术时间、术中出血量、手术切口、复位质量及术后1、3、12个月的Harris评分、日常生活活动(ADL)评分,记录两组不良反应发生情况。结果观察组手术时间、手术切口均短于对照组,术中出血量低于对照组,差异有统计学意义(P<0.05)。两组复位质量比较,差异无统计学意义(P>0.05)。两组术后12个月的Harris、ADL评分均高于术后1、3个月,差异有统计学意义(P<0.05)。观察组术后1个月Harris、ADL评分均高于同期对照组,差异有统计学意义(P<0.05)。两组术后再输血例数比较,差异无统计学意义(P>0.05)。结论自制进针导向器在PFNA微创手术治疗老年股骨粗隆区骨折能够快速准确进针,减少手术时间、术中出血量,缩短手术切口,术后髋关节功能恢复和日常生活活动能力恢复满意,值得临床推广应用。Objective To evaluate the application of self-made needle guide in the treatment of type A2 femoral trochanteric fractures in the elderly patients with proximal femoral nail antirotating(PENA)microtraumatic operation.Methods A total of 62 elderly patients with type A2 femoral trochanteric fracture admitted to Wuhu Hospital of Traditional Chinese Medicine,Anhui Province(hereinafter referred to as“our hospital”),from February 2019 to June 2020 were selected and divided into observation group(31 cases)and control group(31 cases)by computer random method.The observation group received PFNA microtraumatic operation,and the our hospital self-made PFNA needle guide was used in the operation.The control group received conventional PFNA operation.Operation time,intraoperative blood loss,operative incision,reduction quality,and Harris,daily living activity(ADL)scores at 1,3,and 12 months after operation were compared between the two groups,and the incidence of adverse reactions between the two groups was recorded.Results The operation time and incision of the observation group were shorter than those of the control group,and the amount of intraoperative blood loss was lower than that of the control group,the differences were statistically significant(P<0.05).There was no significant difference in reduction quality between the two groups(P>0.05).Harris and ADL scores of the two groups at 12 months after operation were higher than those at one and three months after operation,the differences were statistically significant(P<0.05).The Harris and ADL scores of the observation group one month after operation were higher than those of the control group at the same time,the differences were statistically significant(P<0.05).There was no significant difference in numbers of postoperative retransfusion between the two groups(P>0.05).Conclusion Self-made needle guide in PFNA microtraumatic operation for the treatment of elderly patients with femoral trochanteric fractures can be quickly and accurately injected,reduce the operati

关 键 词：微创手术 股骨粗隆区骨折 防旋股骨近端髓内钉 老年人 

分 类 号：R681.8[医药卫生—骨科学]