股骨近端防旋髓内钉及股骨近端解剖锁定钢板治疗股骨粗隆间骨折患者的效果研究  

Study on effect of proximal femoral anti-rotation intramedullary nail and proximal femoral anatomical locking plate in the treatment of patients with femoral intertrochanteric fracture

作　　者：张兴华 崔若承 焦旭鹏 ZHANG Xing-hua;CUI Ruo-cheng;JIAO Xu-peng(The Second People's Hospital of Boxing County,Binzhou 256505,China)

机构地区：[1]博兴县第二人民医院,256505

出　　处：《中国实用医药》2025年第1期32-36,共5页China Practical Medicine

摘　　要：目的研究股骨近端防旋髓内钉(PFNA)及股骨近端解剖锁定钢板(ALP)治疗股骨粗隆间骨折的效果。方法选取股骨粗隆间骨折患者80例,按照治疗方法不同分为研究组和对照组,每组40例。研究组采用PFNA治疗,对照组采用股骨近端ALP治疗。比较两组患者临床指标、骨代谢指标[Ⅰ型前胶原氨基端前肽(PⅠNP)、Ⅰ型胶原羧基端肽(CTX)]、术后并发症发生率、治疗满意度。结果研究组手术时间(65.39±3.48)min、手术切口长度(5.48±1.61)cm、住院时间(8.08±1.37)d、下床活动时间(7.98±1.21)d均短于对照组的(82.43±5.50)min、(14.87±1.86)cm、(15.23±1.52)d、(14.03±1.39)d,术中出血量(143.59±22.33)ml、术后引流量(55.30±13.89)ml均少于对照组的(247.29±22.37)、(98.48±13.78)ml(P<0.05)。治疗后,研究组PⅠNP(85.20±3.26)ng/ml明显高于对照组的(75.23±3.31)ng/ml,CTX(488.82±24.35)ng/L明显低于对照组的(526.04±30.32)ng/L(P<0.05)。研究组术后并发症发生率7.50%低于对照组的25.00%(P<0.05)。研究组治疗满意度92.50%高于对照组的75.00%(P<0.05)。结论PFNA治疗股骨粗隆间骨折,能够缩短患者的手术时间与康复时间,改善骨代谢指标,术后并发症发生风险低,临床应该进行更多的推广。Objective To study the effect of proximal femoral anti-rotation intramedullary nail(PFNA)and proximal femoral anatomical locking plate(ALP)in the treatment of patients with femoral intertrochanteric fracture.Methods A total of 8 patients with femoral intertrochanteric fracture were selected and divided into study group and control group according to different therapies,with 40 cases in each group.The study group was treated with PFNA,and the control group was treated with proximal femoral ALP.The clinical indexes,bone metabolism indexes[procollagen typeⅠamino terminal propeptide(PⅠNP),N-terminal propeptide of typeⅠprocollagen(CTX)],incidence of postoperative complications and treatment satisfaction were compared between the two groups.Results In the study group,the operation time was(65.39±3.48)min,the surgical incision length was(5.48±1.61)cm,the hospital stay was(8.08±1.37)d,and the ambulation time was(7.98±1.21)d,which were shorter than(82.43±5.50)min,(14.87±1.86)cm,(15.23±1.52)d,and(14.03±1.39)d in the control group;the intraoperative blood loss was(143.59±22.33)ml and the postoperative drainage was(55.30±13.89)ml,which were less than(247.29±22.37)and(98.48±13.78)ml in the control group(P<0.05).After treatment,PⅠNP of(85.20±3.26)ng/ml in the study group was significantly higher than(75.23±3.31)ng/ml in the control group,and CTX of(488.82±24.35)ng/L was significantly lower than(526.04±30.32)ng/L in the control group(P<0.05).The incidence of postoperative complications of 7.50%in the study group was lower than 25.00%in the control group(P<0.05).The treatment satisfaction of 92.50%in the study group was higher than 75.00%in the control group(P<0.05).Conclusion The application of PFNA in the treatment of femoral intertrochanteric fracture can shorten the operation time and rehabilitation time,improve the bone metabolism indexes of patients,and the risk of postoperative complications is relatively low,so it is recommended.

关 键 词：股骨近端防旋髓内钉 股骨近端解剖锁定钢板 股骨粗隆间骨折 骨代谢 

分 类 号：R687.3[医药卫生—骨科学]