唑来膦酸联合髋关节置换术治疗老年骨质疏松性股骨粗隆间骨折的临床效果  

Clinical Outcomes of Zoledronic Acid Combined with Hip Replacement for Osteoporotic Femoral Intertrochanteric Fractures in Elderly Patients

作　　者：郭昆 杨晓峰[1] 杨小伟[1] 郑欣 李洪伟 GUO Kun;YANG Xiaofeng;YANG Xiaowei;ZHENG Xin;LI Hongwei(Department of orthopedics,Xuzhou Cancer hospital,Xuzhou,Jiangsu 221000;Affliated hospital of Xuzhou medical university)

机构地区：[1]徐州市肿瘤医院骨科,江苏徐州221000 [2]徐州医科大学附属医院

出　　处：《中国伤残医学》2024年第5期63-67,共5页Chinese Journal of Trauma and Disability Medicine

基　　金：江苏省徐州市推动科技创新项目:KC19063。

摘　　要：目的:研究评估唑来膦酸联合髋关节置换术治疗老年骨质疏松性股骨粗隆间骨折的临床效果.方法:选择2020年1月-2021年3月徐州市肿瘤医院骨科收治的81例老年骨质疏松性股骨粗隆间骨折患者作为研究对象.按照随机数字表法将其分为治疗组(n=40)和对照组(n=41).对照组患者术前及术后长期口服钙尔奇D及阿法骨化醇,治疗组在对照组基础上于术后1周内静脉滴注唑来膦酸,之后以每年1次的频率应用唑来膦酸.比较2组患者骨密度、患侧髋功能改善情况及再发骨折发生率.结果:术后6、12个月,治疗组的骨密度均高于对照组,疼痛视觉模拟评分均显著低于对照组,组间差异有统计学意义(P<0.05).同时,治疗组的Harris评分明显高于对照组,差异有统计学意义(P<0.05).术后12个月,2组老年骨质疏松性股骨粗隆间骨折患者均未出现不良反应.此外,治疗组在术后12个月内再次骨折的发生率明显低于对照组,差异有统计学意义(P<0.05).结论:通过早期应用唑来膦酸联合髋关节置换术可改善老年骨质疏松性股骨粗隆间骨折患者骨密度,改善其临床症状,降低骨折复发风险.Objective:To assess the clinical efficacy of zoledronic acid combined with total hip arthroplasty in treating elderly patients with osteoporotic femoral intertrochanteric fractures.Methods:81 elderly patients with osteoporotic femoral intertrochanteric fractures admitted to the Department of Orthopedics of Xuzhou Cancer Hospital from January 2020 to March 2021 were selected as the study objects.These patients were randomly divided into a treatment group(n=40)and a control group(n=41)using a random number table method.The control group received preoperative and postoperative long-term oral calcium carbonate D and Alfacalcidol.In addition to the regimen of the control group,the treatment group received Zoledronic Acid intravenous infusion within 1 week after surgery,followed by annual application of zoledronic Acid.The bone density,improvement of hip function,and the incidence of recurrent fractures were compared between the two groups.Results:At 6,12 months after operation,bone mineral density in the treatment group were higher than those in the control group,visual analogue pain scores in the treatment group were significantly lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).Meanwhile,the Harris score of the treatment group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).12 months after operation,there were no adverse reactions in both groups of elderly patients with osteoporotic intertrochanteric fracture of femur.In addition,the incidence of re-fracture in the treatment group was significantly lower than that in the control group within 12 months after operation,and the difference was statistically significant(P<0.05).Conclusion:Early application of Zoledronic Acid combined with total hip arthroplasty can improve bone density,alleviate clinical symptoms,and reduce the risk of osteoporotic fracture recurrence in elderly patients with intertrochanteric femoral fractures.

关 键 词：骨质疏松 股骨粗隆间骨折 唑来膦酸 髋关节置换 

分 类 号：R683[医药卫生—骨科学]