PFNA和ALP治疗股骨转子间骨折患者的疗效及对血清SO、DKK-3水平的影响  

Efficacy of PFNA and ALP in the treatment of patients with femoral intertrochanteric fractures and the effects on serum SO and DKK-3 levels

作　　者：蒋科[1] 向超 JIANG Ke;XIANG Chao(Department of Orthopedics,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院骨科,四川南充637000

出　　处：《医师在线》2024年第4期80-83,共4页Journal of Doctors Online

基　　金：四川省医学会静脉栓塞栓塞症防治(恒瑞)专项科研课题(2019HR14)。

摘　　要：目的 探究股骨近端防旋型髓内钉(PFNA)和股骨近端解剖型锁定钢板(ALP)治疗股骨转子间骨折患者的疗效及对血清骨硬化蛋白(SO)、Dickkopf-3(DKK-3)水平的影响.方法 选取我院2021年4月1日~2023年3月31日符合条件的78例股骨转子间骨折患者,按照抽签法分为对照组(n=39)和研究组(n=39).对照组患者采用ALP髓外固定治疗,研究组患者采用PFNA髓内固定治疗.评估两组患者的手术相关临床指标、并发症情况以及治疗前后的Harris评分、血清DKK-3与SO水平.结果 研究组患者的手术时间、住院时间、下地负重时间、切口长度明显短于对照组,术中出血量明显少于对照组,差异有统计学意义(P<0.05);治疗后,研究组髋内翻、内固定物松动、感染、静脉血栓、压疮、关节脱位等并发症的总发生率明显低于对照组,差异有统计学意义(P<0.05);治疗前两组疼痛、功能、活动度评分比较,差异无统计学意义(P>0.05),治疗后研究组疼痛、功能、活动度评分均明显高于对照组,差异有统计学意义(P<0.05);治疗前两组血清DKK-3、SO水平比较,差异无统计学意义(P>0.05),治疗后研究组血清DKK-3、SO水平明显低于对照组,差异有统计学意义(P<0.05).结论 相较于ALP髓外固定治疗,PFNA髓内固定治疗在股骨转子间骨折患者中的应用效果更好,可加速患者术后恢复速度,提高患者髋关节功能,降低并发症发生率,并改善患者血清DKK-3、SO水平.Objective To investigate the efficacy of proximal femoral anti-rotation intramedullary nail(PFNA)and anatomical proximal femoral locking plate(ALP)in the treatment of patients with femoral intertrochanteric fractures and the effects on serum sclerostin(SO)and Dickkopf-3(DKK-3)levels.Methods 78 eligible patients with femoral intertrochanteric fractures in our hospital from April 1,2021 to March 31,2023 were selected and divided into control group(n=39)and study group(n=39)according to lottery method.The control group was treated with ALP extramedullary fixation,and the study group was treated with PFNA intramedullary fixation.The operation-related clinical indicators,complications,Harris scores,serum DKK-3 and SO levels before and after treatment were evaluated in both groups.Results The operation time,hospitalization time,weight-bearing time and incision length in the study group were significantly shorter than those in the control group,and the intraoperative blood loss was significantly less than that in the control group,the differences were statistically significant(P<0.05).After treatment,the total incidence of complications such as hip varus,loose internal fixation,infection,venous thrombosis,pressure sores and joint dislocation in the study group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant difference in pain,function and activity scores between the two groups(P>0.05).After treatment,the pain,function and activity scores in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).There was no statistical significance in serum DKK-3 and SO levels between the two groups before treatment(P>0.05).After treatment,serum DKK-3 and SO levels in the study group were significantly lower than those in the control group,with statistical significance(P<0.05).Conclusion Compared with ALP extramedullary fixation,PFNA intramedullary fixati

关 键 词：股骨近端防旋型髓内钉 股骨近端解剖型锁定钢板 股骨转子间骨折 血清SO 血清DKK-3 

分 类 号：R68[医药卫生—骨科学]