PFNA治疗老年不稳定型股骨转子间骨折的应用效果及对创伤应激程度的影响  

Effect of PFNA on the Treatment of Unstable Intertrochanteric Fractures in the Elderly and its Influence on the Degree of Traumatic Stress

作　　者：王敬文 王营营 WANG Jingwen;WANG Yingying(Department of orthopedics,Feicheng Peoples hospital,Feicheng,Shandong 271600;Feicheng hospital,Shandong Guoxin nursing Group,Feicheng,Shandong 271608)

机构地区：[1]肥城市人民医院骨科,山东肥城271600 [2]山东国欣颐养集团肥城医院

出　　处：《中国伤残医学》2023年第14期1-4,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:采用股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)治疗老年不稳定型股骨转子间骨折患者,探究该治疗方式对创伤应急程度、术后康复情况、并发症发生情况的影响。方法:将我院2019年1月-2021年12月收治的80例老年不稳定型股骨转子间骨折患者纳入本研究。按不同治疗方法进行分组,对照组(40例)接受动力髋螺钉(dynamic hip screw,DHS)治疗,观察组(40例)接受PFNA治疗。比较术前、术后2组髋关节功能(Harris)评分,同时比较其围手术指标、并发症(切口感染、螺钉切出、大腿疼痛)发生概率,并采用皮质醇(cortisol,Cor)、去甲肾上腺素(norepinephrine,NE)、白介素-6(in-terleukin6,IL-6)、肿瘤坏死因子-α(tumornecrosis factorα,TNF-α)评估其创伤应激指标水平。结果:术中出血量、下地负重时间、切口长度均为观察组少于对照组(P<0.05);2组术后Harris评分均高于术前,观察组术后Harris评分高于对照组(P<0.05);2组术后Cor、NE、IL-6、TNF-α均有所上升,但观察组低于对照组(P<0.05);观察组切口感染、螺钉切出、大腿疼痛等并发症发生率低于对照组(P<0.05)。结论:PFNA是可以提高老年不稳定型股骨转子间骨折髋关节功能恢复的手术治疗方式,该治疗方式手术切口较短,可以有效减少术中出血量,快速恢复下床负重,减轻创伤应激反应,且较少引发并发症。Objective:To investigate the application effect of proximal femoral nail antirotation(PFNA)in elderly patients with un-stable intertrochanteric fractures and its effect on traumatic stress.Methods:A total of 80 elderly patients with unstable intertrochanteric fracture admitted to our hospital from January 2019 to December 2021 were selected as the research objects for retrospective analysis.Ac-cording to different treatment methods,they were divided into control group and observation group,40 cases each group.The control group received dynamic hip screw(DHS)treatment,and the observation group received PFNA treatment.The perioperative indicators and complications of the two groups,and the Harris hip function score was compared before and after operation,and the levels of traumat-ic stress indexes were evaluated by cortisol(Cor),norepinephrine(NE),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α).Results:The intraoperative blood loss,operation time and weight-bearing time in the observation group were less than those in the control group(P<0.05).The Harris hip function score in the observation group was higher than that before operation and higher than that in the control group(P<0.05).Cor,NE,IL-6 and TNF-αincreased in the two groups after operation,but the observation group was lower than the control group(P<0.05).The incidence of complications such as incision infection,screw cut out and thigh pain in the observation group was lower than that in the control group(P<0.05).Conclusion:PFNA treatment for unstable intertro-chanteric fracture of femur in elderly patients can effectively reduce intraoperative blood loss,shorten operation time,get out of bed weight bearing time,reduce traumatic stress reaction,and improve the recovery effect of hip joint function,and fewer complications.

关 键 词：老年 股骨转子间骨折 不稳定型 创伤应激程度 PFNA 

分 类 号：R683.42[医药卫生—骨科学]