应用股骨近端防旋髓内钉治疗老年股骨粗隆间骨折对术后疼痛的影响  

Effect of Proximal Femoral Nail Autirotation on Postoperative Pain in Elderly Patients with Intertrochanteric Fracture of Femur

作　　者：李均保 金航辉 林郁[1] LI Junbao;JIN Hanghui;LIN Yu(Department of Orthopedics,Shouning County Hospital,Shouning,Fujian,355500,China)

机构地区：[1]寿宁县医院骨科,福建寿宁355500

出　　处：《中外医疗》2024年第33期1-5,共5页China & Foreign Medical Treatment

摘　　要：目的 探究老年股骨粗隆间骨折患者治疗中,采用股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)的效果和价值。方法 回顾性选取2022年1月—2024年1月寿宁县医院骨科收治的78例老年股骨粗隆间骨折患者的临床资料,按照不同术式分组,对照组39例予以股骨近端解剖型锁定钢板治疗、观察组39例予以PFNA治疗。比较两组围手术期指标、并发症、疼痛、骨碱性磷酸酶水平以及髋关节功能和生活质量。结果 观察组手术时间、术中出血量、切口长度、下地负重时间、住院时间均优于对照组,差异均有统计学意义(P均<0.05)。观察组并发症总发生率为7.68%(3/39)低于对照组的25.62%(10/39),差异有统计学意义(χ^(2)=4.523,P<0.05)。术后7 d、1个月及3个月,观察组视觉模拟评分(Visual Analogue Scale,VAS)均低于对照组,差异均有统计学意义(P均<0.05)。术后3个月,观察组骨碱性磷酸酶水平、髋关节功能评分、生活质量评分均优于对照组,差异均有统计学意义(P均<0.05)。结论 在老年股骨粗隆间骨折治疗中,采取PFNA方案,可进一步优化围手术期指标,减少并发症,降低疼痛,改善骨碱性磷酸酶水平和髋关节功能,同时也可以提高患者生活质量。Objective To explore the effect and value of proximal femoral nail antirotation(PFNA) in the treatment of elderly patients with intertrochanteric fracture of femur.Methods The clinical data of 78 elderly patients with intertrochanteric fractures admitted to the Department of Orthopedics,Shouning County Hospital from January 2022 to January 2024 were retrospectively selected.According to different surgical methods,39 patients in the control group were treated with proximal femoral anatomical locking plate,and 39 patients in the observation group were treated with PFNA.Perioperative indicators,complications,pain,bone alkaline phosphatase level,hip function and quality of life were compared between the two groups.Results The operation time,intraoperative blood loss,incision length,weight-bearing time and hospitalization time in the observation group were better than those in the control group,and the differences were statistically significant(all P<0.05).The total incidence of complications in the observation group was 7.68%(3/39),which was lower than 25.62%(10/39) in the control group,and the difference was statistically significant(χ^(2)=4.523,P<0.05).At 7 days,1 month and 3 months after operation,the Visual Analogue Scale(VAS) of the observation group was lower than that of the control group,and the difference was statistically significant(all P<0.05).At 3 months after operation,the bone alkaline phosphatase level,hip joint function score and quality of life score in the observation group were better than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion In the treatment of intertrochanteric fractures in the elderly,PFNA can further optimize perioperative indicators,reduce complications,reduce pain,improve bone alkaline phosphatase level recovery and hip function,and also improve the quality of life of patients.

关 键 词：股骨粗隆间骨折 股骨近端解剖型锁定钢板 股骨近端防旋髓内钉 并发症 疼痛 髋关节功能 

分 类 号：R816.8[医药卫生—放射医学]