不同手术方法对高龄股骨粗隆间骨折患者术后围手术期指标、髋关节功能及并发症的影响  

Effects of Different Surgical Methods on Perioperative Indicators,Hip Joint Function and Complications in Elderly Patients with Intertrochanteric Fracture of Femur

作　　者：赵官平 ZHAO Guanping(The Second Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330012,China)

机构地区：[1]江西中医药大学第二附属医院,江西南昌330012

出　　处：《中国医学创新》2023年第9期23-26,共4页Medical Innovation of China

摘　　要：目的:探究不同手术方法对高龄股骨粗隆间骨折患者术后围手术期指标、髋关节功能及并发症的影响。方法:回顾性分析2019年3月-2021年7月于江西中医药大学第二附属医院接受手术治疗的84例高龄股骨粗隆间骨折患者的临床资料,依据目前临床上常用的手术方法不同分为股骨近端解剖型锁定钢板(ALP)组(n=34)与股骨近端防旋髓内钉(PFNA)组(n=50)。ALP组行ALP治疗,PFNA组行PFNA治疗。对比两组围手术期指标、并发症及髋关节功能优良率。结果:PFNA组切口长度为(7.03±1.97)cm,短于ALP组的(14.55±3.28)cm;PFNA组术中出血量为(142.48±25.53)mL、术后引流量为(55.31±13.67)mL,均少于ALP组的(246.84±26.86)mL、(98.63±15.67)mL;PFNA组手术时间为(45.71±7.89)min、术后下床活动时间为(7.57±2.73)d、住院时间为(8.42±1.31)d、骨折愈合时间为(10.62±1.67)周,均短于ALP组的(82.61±8.85)min、(14.78±3.49)d、(15.33±3.15)d、(14.10±1.75)周(P<0.05);PFNA组并发症发生率(2.00%)低于ALP组(26.47%)(P<0.05);PFNA组Harris髋关节功能优良率为92.00%,ALP组Harris髋关节功能优良率为85.29%,两组比较差异无统计学意义(P>0.05)。结论:PFNA与ALP均可治疗股骨粗隆间骨折,但PFNA操作方法更方便,切口长度较短,术中出血量较少,手术时间较短等,且术后髋关节功能的恢复较好,并发症少,安全性较高,有利于骨折端的恢复,值得推广。Objective:To explore the effects of different surgical methods on perioperative indicators,hip function and complications in elderly patients with intertrochanteric fracture of femur.Method:The clinical data of 84 elderly patients with intertrochanteric fracture who underwent surgical treatment in the Second Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from March 2019 to July 2021 were retrospectively analyzed.They were divided into the proximal femoral anatomic locking plate(ALP)group(n=34)and the proximal femoral anti-rotation intramedullary nail(PFNA)group(n=50)according to different surgical methods commonly used in clinic.ALP group was treated with ALP,PFNA group was treated with PFNA.The perioperative indicators,complications and excellent and good rate of hip joint function were compared between the two groups.Result:The incision length of PFNA group was(7.03±1.97)cm,shorter than(14.55±3.28)cm of ALP group;the intraoperative bleeding volume of PFNA group was(142.48±25.53)mL,and the postoperative drainage volume was(55.31±13.67)mL,which were lower than(246.84±26.86)mL,(98.63±15.67)mL of ALP group;the operation time in PFNA group was(45.71±7.89)min,the time to get out of bed after operation was(7.57±2.73)d,the hospital stay was(8.42±1.31)d,and the fracture healing time was(10.62±1.67)weeks,which were shorter than(82.61±8.85)min,(14.78±3.49)d,(15.33±3.15)d,(14.10±1.75)weeks in ALP group(P<0.05);the complication rate of PFNA group(2.00%)was lower than that of ALP group(26.47%)(P<0.05);the excellent and good rate of Harris hip joint function in PFNA group and ALP group was 92.00%and 85.29%respectively,there was no significant difference between the two groups(P>0.05).Conclusion:Both PFNA and ALP can treat intertrochanteric fracture of femur,but PFNA is more convenient,with shorter incision length,less intraoperative bleeding,shorter operation time,etc,and the postoperative hip function recovery is better,with fewer complications and higher safety,which is conducive to

关 键 词：股骨粗隆间骨折 高龄患者 股骨近端解剖型锁定钢板内固定术 股骨近端防旋髓内钉内固定术 髋关节功能 并发症 

分 类 号：R687.3[医药卫生—骨科学]