PFNA与Inter Tan内固定联合抗骨质疏松治疗伴骨质疏松股骨粗隆间骨折患者的效果  

Effect of Combined Anti-osteoporotic Treatment of PFNA and Inter Tan Internal Fixation in Patients with Osteoporotic Intertrochanteric Femur Fracture

作　　者：李玉华[1] 马梓昆 冯子攀 翟功伟 范志远 LI Yuhua;MA Zikun;FENG Zipan;ZHAI Gongwei;FAN Zhiyuan(Department of Orthopedics,the Fifth Clinical Medical College of Henan University of Chinese Medicine People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)骨科,河南郑州450000

出　　处：《河南医学研究》2025年第3期444-448,共5页Henan Medical Research

摘　　要：目的观察股骨近端抗旋转髓内钉(PFNA)与Inter Tan内固定联合抗骨质疏松治疗伴骨质疏松股骨粗隆间骨折患者的效果。方法将2020年1月至2023年4月就诊于郑州人民医院的60例伴骨质疏松股骨粗隆间骨折患者采用随机法分为两组,PFNA组接受PFNA内固定联合抗骨质疏松治疗,Inter Tan组接受Inter Tan内固定联合抗骨质疏松治疗。比较两组临床效果。结果Inter Tan组负重活动时间[(60.88±8.41)周]、早期下地行走时间[(5.94±1.07)d]短于PFNA组,切口长度[(8.61±0.87)cm]小于PFNA组,术中透视次数[(4.95±0.94)次]、术中出血量[(204.15±26.22)mL]多于PFNA组,血红蛋白(Hb)[(18.56±4.74)g·L^(-1)]和血细胞比容(Hct)下降值[(4.16±0.59)%]高于PFNA组,手术时间[(123.26±23.36)min]长于PFNA组,差异有统计学意义(P<0.05)。两组术后24周Harris评分及碱性磷酸酶(BALP)、总Ⅰ型胶原氨基端延长肽(tPⅠNP)、骨钙素(OC)较高于术前,视觉模拟评分法(VAS)评分、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)低于术前,差异有统计学意义(P<0.05)。Inter Tan组术后24周Harris评分高于PFNA组,VAS评分低于PFNA组,差异有统计学意义(P<0.05)。Inter Tan组解剖复位优良率高于PFNA组,内固定松动率与PFNA组比较,差异无统计学意义(P>0.05)。结论Inter Tan内固定与PFNA内固定联合抗骨质疏松治疗伴骨质疏松股骨粗隆间骨折相比,Inter Tan内固定切口小,术后髋关节功能恢复好,术后解剖复位优良率高,但手术时间长,术中透视次数相对较多。Objective To observe the effect of proximal femoral anti-rotational intramedullary nailing(PFNA)and Inter Tan internal fixation combined with anti-osteoporotic treatment on hip function and postoperative bone healing indexes in patients with osteoporotic intertrochanteric femoral fractures.Methods Sixty patients with osteoporotic intertrochanteric femur fractures who attended People’s Hospital of Zhengzhou from January 2020 to April 2023 were divided into two groups by randomization method,the PFNA group received PFNA internal fixation combined with anti-osteoporosis treatment,and the Inter Tan group received Inter Tan internal fixation combined with anti-osteoporosis treatment.The clinical outcomes of the two groups were compared.Results Weight-bearing activity time[(60.88±8.41)weeks],early time to walk on the ground[(5.94±1.07)d]in Inter Tan group were shorter than those in the PFNA group,incision length[(8.61±0.87)cm]was smaller than in the PFNA group,the number of intraoperative fluoroscopies[(4.95±0.94)times],intraoperative bleeding[(204.15±26.22)mL]in Inter Tan group were more than those in the PFNA group,the number of hemoglobin(Hb)[(18.56±4.74)g·L^(-1)]and hematocrit(Hct)decreased value[(4.16±0.59)%]were higher than those of PFNA group,and the operation time[(123.26±23.36)min]was longer than that of PFNA group,and the difference was statistically significant(P<0.05).Harris score and alkaline phosphatase(BALP),total typeⅠcollagen amino-terminal extended peptide(tPⅠNP),osteocalcin(OC)were higher than preoperative at 24 weeks after surgery in both groups,and visual analog scale(VAS)score and type I collagen carboxy-terminal peptideβ-special sequence(β-CTX)were lower than preoperative,and the difference was statistically significant(P<0.05).Harris score of Inter Tan group was higher than that of PFNA group,and VAS score of Inter Tan group was lower than that of PFNA group 24 weeks postoperative,and the difference was statistically significant(P<0.05).The anatomical repositioning excellence ra

关 键 词：骨质疏松 股骨粗隆间骨折 股骨近端抗旋转髓内钉 Inter Tan内固定 

分 类 号：R683[医药卫生—骨科学]