软组织保护对股骨粗隆下骨折患者术后疼痛及髋关节功能的影响  

Effects of soft tissue protection on postoperative pain and hip joint function in patients with femoral subtrochanteric fracture

作　　者：齐巍[1] 高烁[1] 左金增[1] 王一兵[1] 侍朋举[1] 孙柏山[1] 王建生[1] QI Wei;GAO Shuo;ZUO Jinzeng(First Department of Trauma,Tangshan Second Hospital,Hebei,Tangshan 063000,China)

机构地区：[1]河北省唐山市第二医院创伤一科,063000

出　　处：《河北医药》2023年第4期530-533,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20191513)。

摘　　要：目的 探究并分析软组织保护对股骨粗隆下骨折患者术后疼痛及髋关节功能的影响研究。方法 选取2016年8月至2019年8月就诊的老年股骨粗隆下骨折患者89例,按照随机数字表法将其随机分为观察组(n=44例)和对照组(n=45例)。对照组采用髓内钉内固定,观察组采用软组织保护联合髓内钉内固定治疗。观察并比较2组患者一般资料[性别、年龄、体重指数(body mass index, BMI)、术中出血量、手术时间、切口长度、骨折分型等情况],手术前后视觉模拟疼痛评分(visual analogue pain score, VAS),术后髋关节功能恢复评分(Harris评分),2组患者术后6个月并发症发生率。结果 2组患者手术前VAS评分比较差异无统计学意义(P>0.05),术后1 d、术后7 d 2组患者VAS评分较术前显著降低(P<0.05),术后1 d、术后7 d观察组患者VAS评分显著低于对照组(P<0.05);术后3个月、6个月、12个月2组患者Harris评分较术后1个月显著升高(P<0.05),术后1个月、3个月、6个月、12个月观察组患者Harris评分显著高于对照组(P<005);2组患者的术后并发症发生率差异明显(P<0.05),对照组术后并发症总发生率为28.89%,观察组患者总发生率为6.82%,显著低于对照组,差异有统计学意义(P<0.05)。结论 软组织保护联合髓内钉内固定能有效降低老年股骨粗隆下骨折患者术后疼痛,改善患者术后髋关节功能,并降低患者术后并发症的发生率。Objective To explore and analyze the effects of soft tissue protection on postoperative pain and hip joint function in patients with femoral subtrochanteric fracture.Methods Eighty visiting elderly patients with femoral subtrochanteric fracture from January 2016 to January 2019 were randomized to intramedullary nailing(control group)or soft tissue protection+intramedullary nailing(observation group).The general information(gender,age,body mass index(BMI),intra-operative blood loss,time of operation,incision length,fracture classification,etc.),preoperative&postoperative visual analogue pain score(VAS),Harris score of postoperative recovery of hip joint function,and incidence of complications in 6 months after operation between the two groups were observed and compared.Results Difference in VAS score between the two groups before operation wasn’t statistically significant(P>0.05),VAS score in the two groups on 1 day and 7 days after operation was significantly lower than that before operation(P<0.05),VAS score in the observation group in 1 day and 7 days after operation was significantly lower than that in the control group(P<0.05).Harris score in the two groups in 3 months,6 months and 12 months after operation was significantly higher than that in 1 month after operation(P<0.05),which was significantly higher in the observation group than that in the control group in 1 month,3 months,6 months and 12 months after operation(P<0.05);the incidence of postoperative complications in the two groups was significantly different(P<0.05);the total incidence of postoperative complications in the control group was significantly lower than that in the observation group(28.89%vs 6.82%,P<0.05).Conclusion Soft tissue protection combined with intramedullary nailing supports effectively reducing the postoperative pain of elderly patients with femoral subtrochanteric fracture,improving the postoperative hip joint function,and lowering the incidence of postoperative complications.

关 键 词：股骨粗隆下骨折 老年患者 软组织保护 髓内钉 髋关节功能 

分 类 号：R683.42[医药卫生—骨科学]