PFNA内固定术中徒手置入导针治疗股骨粗隆间骨折患者的效果分析  

Effect Analysis of the Treatment of Patients with Intertrochanteric Fracture of Femur with Guide Needle Inserted by Hand during PFNA Internal Fixation

作　　者：曾涛 刘敏剑 肖树荣 ZENG Tao;LIU Minjian;XIAO Shurong(Department of Orthopedics,Longnan First People’s Hospital,Ganzhou 341000,China)

机构地区：[1]江西省龙南市第一人民医院骨科,江西赣州341000

出　　处：《中国伤残医学》2024年第23期14-17,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨股骨粗隆间骨折患者采用股骨近端防旋髓内钉(PFNA)内固定术中徒手置入导针治疗的临床效果。方法:选取2022年6月—2024年1月龙南市第一人民医院收治的76例股骨粗隆间骨折患者为研究对象,采用随机数字表法将其分为对照组和研究组,各38例。两组均行PFNA内固定术治疗,对照组术中采用传统方式置入导针,研究组术中采用徒手置入置入导针。两组术后均随访6个月。比较两组临床指标、髋关节功能及并发症发生情况。结果:研究组手术时间、切口长度均短于对照组,术中失血量、术中透视次数均少于对照组,差异均有统计学意义(P<0.05)。术前、术后6个月,两组Harris髋关节功能评分量表(HHS)评分比较,差异均无统计学意义(P>0.05);术后1、3个月,研究组HHS评分均高于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为2.63%,低于对照组的7.89%,但两组比较,差异无统计学意义(P>0.05)。结论:与常规置入导针相比,徒手置入导针治疗股骨粗隆间骨折效果更好,可缩短PFNA内固定术操作时间,减少创伤,降低透视次数,减少术中失血量,有利于患者髋关节功能恢复。Objective:To investigate the clinical effect of manual insertion of guide needle in the treatment of patients with intertrochanteric fracture of femur with proximal femoral nail anti-rotation(PFNA).Methods:A total of 76 patients with intertrochanteric fracture of femur admitted to Longnan First People’s Hospital from June 2022 to January 2024 were selected as the study objects,and were divided into control group and study group by random number table method,with 38 cases in each group.Both groups were treated with PFNA internal fixation.The control group was treated with traditional guide needle insertion,while the study group was treated with free hand guide needle insertion.Both groups were followed up for 6 months.The clinical indexes,hip function and complications were compared between the two groups.Results:The operation time and incision length of the study group were shorter than those of the control group,and the intraoperative blood loss and intraoperative fluoroscopy times were less than those of the control group,with statistical significance(P<0.05).Before surgery and 6 months after surgery,there was no significant difference in Harris Hip Function Scale(HHS)scores between the two groups(P>0.05);1 and 3 months after operation,the HHS scores of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the study group was 2.63%,which was lower than 7.89%in the control group,but there was no significant difference between the two groups(P>0.05).Conclusion:Compared with conventional guide needle placement,manual guide needle placement is more effective in the treatment of intertrochanteric fracture of femur,which can shorten the operation time of PFNA internal fixation,reduce trauma,fluoroscopy times and intraoperative blood loss,and is conducive to the recovery of hip joint function.

关 键 词：股骨粗隆间骨折 股骨近端防旋髓内钉内固定术 徒手置入导针 安全性 

分 类 号：R68[医药卫生—骨科学]