防旋型股骨近端髓内钉与加长柄生物型人工关节置换术治疗老年股骨粗隆间骨折的疗效对比  

Comparison on curative effect of proximal femoral intramedullary nail with anti-rotation and biological long-stem total hip arthroplasty in the elderly with intertrochanteric fracture of femur

作　　者：李栋梁 蒋永佳 章华 张鸿飞 崔卓航 LI Dongliang;JIANG Yongjia;ZHANG Hua;ZHANG Hongfei;CUI Zhuohang(Jiujiang 171 Hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江一七一医院,江西九江332000

出　　处：《当代医学》2024年第14期60-64,共5页Contemporary Medicine

摘　　要：目的探讨防旋型股骨近端髓内钉(PFNA)与加长柄生物型人工关节置换术治疗老年股骨粗隆间骨折(IFF)的临床疗效及对骨愈合速度、髓鞘碱性蛋白(MBP)、髋关节功能(Harris)评分的影响。方法选取2018年1月至2022年5月九江一七一医院收治的82例老年IFF患者作为研究对象,按照随机数字表法分为对照组与观察组,每组42例。对照组行PFNA内固定术治疗,观察组行加长柄生物型人工关节置换术治疗,比较两组手术情况、临床疗效、MBP水平、Harris评分及手术安全性。结果观察组手术时间长于对照组,术中出血量多于对照组,住院时间、骨折愈合时间均短于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。术后,两组疼痛、功能及活动范围评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。术后,两组血清MBP水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论PFNA与加长柄人工关节置换术治疗老年股骨粗隆间骨折各有优势,虽然加长柄生物型人工关节置换术治疗老年IFF患者的手术时间较长,但手术效果更佳,可更有效地促进患者骨愈合及功能恢复,抑制MBP释放,并减轻患者疼痛,手术安全性高,值得临床推广应用。Objective To explore clinical effect of proximal femoral intramedullary nail with anti-rotation(PFNA)and biological long-stem total hip arthroplasty and their influences on bone healing rate,myelin basic protein(MBP)and score of hip function(Harris)in the elderly with intertrochanteric fracture of femur(IFF).Methods 82 elderly patients with IFF admitted to Jiujiang 171 Hospital from January 2018 to May 2022 were selected as the research subjects,they were divided into the control group and the observation group according to random number table method,the control group was treated with PFNA internal fixation,and the observation group was treated with biological long-stem total hip arthroplasty,42 cases in each group,the surgical situation,clinical efficacy,MBP level,Harris scores and surgical safety were compared between the two groups.Results The operation time in the observation group was longer than that in the control group,intraoperative blood loss was more than that in the control group,hospitalization time and fracture healing time were shorter than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).After surgery,the scores of pain,function and range of motion of the two groups were higher than those before surgery,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).After surgery,the level of serum MBP of the two groups were lower than hose before surgery,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion PFNA and biological long-stem total hip arthroplasty have respective advantages in the elderly patients with IFF,although the latter has

关 键 词：股骨粗隆间骨折 老年 股骨近端髓内钉 加长柄生物型人工关节置换术 骨愈合 HARRIS评分 

分 类 号：R687.3[医药卫生—骨科学]