CT三维重建辅助下股骨近端防旋髓内钉治疗股骨转子间骨折患者的疗效:基于髋关节功能及并发症发生率  

Effect of proximal femoral anti-rotation intramedullary nail assisted by CT threedimensional reconstruction in the treatment of intertrochanteric fracture of femur:based on the hip joint function and the incidence of complications

作　　者：侍从洋 张艳艳 殷照阳 SHI Congyang;ZHANG Yanyan;YIN Zhaoyang(Department of Orthopaedic Trauma,Lianyungang Hospital Affiliated to Xuzhou Medical University(Lianyungang First People's Hospital),Lianyungang 222002,China;Department of Geriatrics,Lianyungang Hospital Affiliated to Xuzhou Medical University(Lianyungang First People's Hospital),Lianyungang 222002,China)

机构地区：[1]徐州医科大学附属连云港医院(连云港市第一人民医院)创伤骨科,江苏连云港222002 [2]徐州医科大学附属连云港医院(连云港市第一人民医院)老年科,江苏连云港222002

出　　处：《分子影像学杂志》2024年第8期856-860,共5页Journal of Molecular Imaging

基　　金：连云港市卫健委面上项目(202212)。

摘　　要：目的探讨CT三维重建辅助下股骨近端防旋髓内钉(PFNA)对股骨转子间骨折患者髋关节功能及并发症发生率的影响。方法选取2020年1月~2022年10月于徐州医科大学附属连云港医院接受治疗的股骨转子间骨折患者98例,采用随机数字表法将患者分为对照组和观察组,49例/组。对照组予以常规PFNA治疗,观察组予以CT三维重建辅助下PFNA治疗,两组均持续于术后进行随访12月。比较两组临床疗效(随访12月后),Harris髋关节评分(术前及术后6、12月)、血栓弹力图参数(术前及术后7 d)、血清因子(术前、及术后3月)、研究期间并发症发生情况。结果随访12月后,观察组总有效率为97.96%,高于对照组的85.71%(P<0.05)。与术前比较,术后6~12月,两组Harris髋关节评分均升高,其中观察组更高(P<0.05)。与术前比较,术后7 d,两组凝血反应时间、凝血形成时间均缩短,其中观察组更短,血凝块形成速率均增大,其中观察组更大(P<0.05)。与术前比较,术后3月,两组血清D-二聚体水平均降低,观察组更低,血清凝血酶原时间值则均缩短,观察组更短,血清骨形态发生蛋白-2和转化生长因子-β1水平均升高,其中观察组更高(P<0.05)。两组患者并发症总发生率的组间差异无统计学意义(P>0.05)。结论股骨转子间骨折患者经CT三维重建辅助下PFNA治疗可有效提高骨折愈合因子水平,改善患者凝血功能及血栓弹力图参数,促进其髋关节功能的恢复,安全性良好的同时疗效显著。Objective To investigate the effect of proximal femoral anti-rotation intramedullary nail(PFNA)assisted by CT threedimensional reconstruction on hip joint function and the incidence of complications in patients with intertrochanteric fracture of the femur.Methods Ninety-eight patients with intertrochanteric fracture who received treatment at Lianyungang Hospital affiliated to Xuzhou Medical University from January 2020 to October 2022 were included,and they were divided into the control group and the observation group by random number table method,with 49 cases in each group.The control group was treated with conventional PFNA,while the observation group was treated with PFNA assisted by CT three-dimensional reconstruction.Both groups were followed up for 12 months after operation.The clinical efficacy(12 months after follow-up),score of Harris hip(preoperative,postoperative 6 months,postoperative 12 months),thromboelastogram parameters(preoperative,postoperative 7 d),serum factors(preoperative,postoperative 3 months)and complications(during the study period)were compared between the two groups.Results After a follow-up of 12 months,the total effective rate in the observation group was 97.96%,which was higher than that in the control group(85.71%)(P<0.05).Compared with before operation,score of Harris hip increased in both groups from 6 to 12 months after operation,especially in the observation group(P<0.05).Compared with before operation,on 7th day after operation,coagulation reaction time and coagulation formation time in both groups shortened,the observation group was shorter,while blood clot formation rate increased,and the observation group was larger(P<0.05).Compared with before operation,3 months after operation,the levels of serum D-dimer in both groups decreased,and the values of serum prothrombin time were all shortened,and the levels of serum bone morphogenetic protein-2 and transforming growth factor-β1 all increased,the observation group was higher(P<0.05).During the study period,there was no signif

关 键 词：股骨转子间骨折 电子计算机断层扫描 三维重建 股骨近端防旋髓内钉 髋关节功能 并发症 

分 类 号：R687.3[医药卫生—骨科学] R816.8[医药卫生—外科学]