APFN与PFNA内固定治疗老年股骨粗隆间骨折的疗效比较  

Comparison of Efficacy of APFN and PFNA in the Treatment of Elderly Intertrochanteric Fractures

作　　者：黎志超 李雪纯 刘孟孟 高清英 LI Zhichao;LI Xuechun;LIU Mengmeng;GAO Qingying(Department of OrthopaedicsⅡ,Shaowu Municipal Hospital,Shaowu,Fujian Province,354000 China)

机构地区：[1]邵武市立医院骨二科,福建邵武354000

出　　处：《中外医疗》2023年第18期61-64,共4页China & Foreign Medical Treatment

基　　金：南平市自然科学基金联合资助项目(2019J47)。

摘　　要：目的分析股骨粗隆间骨折特点,对比评估APFN、PFNA内固定治疗老年患者的预后情况,为骨科疾病治疗提供参考。方法随机选取2018年1月—2021年1月期间邵武市立医院骨二科收治的40例股骨粗隆间骨折患者(年龄≥70岁)作为研究对象,40例患者均属于Evans分型Ⅰ型(两骨折块且无移位),随机分为对照组和观察组,每组20例。观察组采用股骨近端髓内钉(asian type proximal femoral nail,APFN)治疗,对照组采用股骨近端防旋髓内钉(proximal femoral nail anti-rotation,PFNA)治疗。比较两组治疗效果、围术期指标以及患者术后3个月的生活质量状况、患者治疗满意度情况。结果观察组治疗有效率为100.00%,明显高于对照组,差异有统计学意义(χ^(2)=4.902,P<0.05)。观察组手术时间(57.38±15.15)min、术中出血量(118.64±22.07)mL、住院时间、愈合时间、开始负重时间均明显优于对照组,差异有统计学意义(P<0.05)。观察组SF-36评分高于对照组,差异有统计学意义(P<0.05)。观察组满意度较高于照组,差异有统计学意义(P<0.05)。结论老年股骨粗隆间骨折直接影响患者基本生活。治疗方面,APFN疗效较为理想,同时可以改善各项手术指标,提升了患者生活质量,满足其手术治疗需求。Objective To analyze the characteristics of intertrochanteric fracture of femur,compare and evaluate the prognosis of elderly patients treated with APFN and PFNA internal fixation,and provide reference for orthopedic disease treatment.Methods From January 2018 to January 2021,40 patients(aged≥70 years)with intertrochanteric fracture of the femur admitted to the Department of OrthopaedicsⅡof Shaowu Municipal Hospital were randomly selected as the research objects.All 40 patients belonged to Evans type I(two fracture fragments without displacement),and were randomly divided into the control group and the observation group,with 20 cases in each group.The observation group was treated with asian type proximal femoral nail(APFN),while the control group was treated with proximal femoral nail anti rotation(PFNA).Compared the treatment effectiveness,perioperative indicators,as well as the quality of life and treatment satisfaction of patients at 3 months after surgery between the two groups.Results The effective rate of treatment in the observation group was 100.00%,significantly higher than that in the control group,the difference was statistically significant(χ^(2)=4.902,P<0.05).The observation group had significantly better surgical time(57.38±15.15)min,intraoperative bleeding volume(118.64±22.07)mL,hospital stay,healing time,and starting weight bearing time than the control group,the difference was statistically significant(P<0.05).The SF-36 scores in the observation group were higher than that in the control group,and the difference was statistically significant(P<0.05).The satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Elderly intertrochanteric fractures of the femur directly affect patients′basic life.In terms of treatment,APFN has ideal efficacy,can improve various surgical indicators,improve the quality of life of patients,and meet the needs of patients for surgical treatment.

关 键 词：股骨粗隆间骨折 老年 内固定 APFN PFNA 疗效 生活质量 满意度 

分 类 号：R4[医药卫生—临床医学]