老年股骨近端骨折患者采用PFNA内固定术治疗效果  

The Therapeutic Effect of PFNA Internal Fixation in Elderly Patients with Proximal Femoral Fractures

作　　者：王伟 刘丽 WANG Wei;LIU Li(Infection Management Office,Jinan Seventh People's Hospital,Jinan Shandong 250101,China;Department of Hemodialysis,Jinan Seventh People's Hospital,Jinan Shandong 250101,China)

机构地区：[1]济南市第七人民医院医院感染管理办公室,山东济南250101 [2]济南市第七人民医院血液透析科,山东济南250101

出　　处：《中国卫生标准管理》2024年第24期132-135,共4页China Health Standard Management

摘　　要：目的探讨股骨近端骨折的老年患者运用防旋型股骨近端髓内钉(proximal femoral nail antirotation,PFNA)内固定术治疗的效果。方法选取股骨近端骨折的老年患者共80例,均为济南市第七人民医院2020年2月—2021年2月收治,严格依据随机原则做分组处理,各40例。对照组运用动力髋螺钉(dynamic hip screw,DHS)固定术方案,观察组运用PFAN方案,对比不同组别手术总有效率、围手术期指标值、髋关节功能评测分值、Ⅰ型前胶原氨基端前肽(procollagen typeⅠN-terminal propeptide,PINP)及炎症因子指标值、并发症发生率。结果观察组总有效率为97.50%,高于对照组82.50%,差异有统计学意义(P<0.05)。观察组手术操作具体用时更短、手术切口长度更短、术中失血量更少、离床活动时间更短、骨折愈合时间更短,与对照组比较,差异有统计学意义(P<0.05)。2组在开展手术前,经评测髋关节功能指标即疼痛、畸形、关节活动度、关节功能项目,差异无统计学意义(P>0.05)。在术后,各项评分均表现为上升趋势,观察组评分更高,差异有统计学意义(P<0.05)。2组在开展手术前,检查PINP、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6),差异无统计学意义(P>0.05);在开展手术后,各值均有降低,观察组数据经观测更低,差异有统计学意义(P<0.05)。观察组有更低的骨折愈合不良、切口感染等并发症发生率,差异有统计学意义(P<0.05)。结论股骨近端骨折的老年患者运用PFNA内固定术展开治疗,可提高总有效率,改善围手术期指标,促进骨折愈合,增强髋关节功能,降低血清炎症因子水平。Objective To explore the effectiveness of using proximal femoral nail antirotation(PFNA)internal fixation for the treatment of elderly patients diagnosed with proximal femoral fractures.Methods A total of 80 elderly patients diagnosed with proximal femoral fractures were selected,all of whom were admitted to Jinan Seventh People's Hospital from February 2020 to February 2021.They were strictly grouped according to the principle of randomization,with 40 cases included in each group.The control group received dynamic hip screw(DHS)fixation surgery,while the observation group received PFNA treatment.The total effective rate of surgery,perioperative index values,hip joint function evaluation scores,procollagen typeⅠN-terminal propeptide(PINP),inflammatory factor index values,and complication rate values were compared among different groups.Results The observation group had a higher total effective rate of 97.50%for the fracture patients involved,which was higher than the control group's 82.50%,with the significant difference(P<0.05).The observation group had shorter surgical operation time,shorter surgical incision length,less intraoperative blood loss,shorter out-of-bed activity time,and shorter fracture healing time compared to the control group,and the differences were statistically siginificant(P<0.05).Before the surgery,the two groups were evaluated for hip joint function indicators,including pain,deformity,joint range of motion,and joint function items.There was no difference between two groups(P>0.05).After the surgery,all scores showed an increase,and the observation group was at a higher level,with the significant difference(P<0.05).Two groups were tested for PINP,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),which showed no significant difference(P>0.05).After surgery,all values decreased,and the observation group data showed lower values,with the significant difference(P<0.05).The observation group had a lower incidence of complications such as poor fracture healing and incision infection,with

关 键 词：老年 股骨近端骨折 PFNA内固定术 髋关节功能 炎症因子 骨折愈合 

分 类 号：R683[医药卫生—骨科学]