人工股骨头置换与股骨近端防旋髓内钉治疗老年不稳定型股骨粗隆间骨折的效果分析  

Effect Analysis of Artificial Femoral Head Replacement Combined with Proximal Femoral Nail Antirotation in the Treatment of Elderly Patients with Unstable Intertrochanteric Femoral Fractures

作　　者：宋业军 SONG Yejun(Department of Orthopedics,Junan Hospital of Traditional Chinese Medicine,Linyi 276000,China)

机构地区：[1]山东省莒南县中医医院骨科,山东临沂276000

出　　处：《中国伤残医学》2024年第23期18-22,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:比较股骨近端防旋髓内钉(PFNA)与人工股骨头置换(AFHR)治疗老年不稳定型股骨粗隆间骨折的效果。方法:回顾性分析2023年1月—2024年1月于莒南县中医医院接受手术治疗的60例老年不稳定型股骨粗隆间骨折患者资料,根据不同手术方式将其分为对照组及研究组,各30例。对照组接受AFHR治疗,研究组接受PFNA治疗。对比两组手术及术后康复指标、应激反应水平、髋关节功能、并发症发生情况。结果:研究组的术中出血量少于对照组,手术时间、术后首次下床时间及住院时间均短于对照组,差异均有统计学意义(P<0.05)。术后,研究组的皮质醇、肾上腺素、去甲肾上腺素水平均低于对照组,差异均有统计学意义(P<0.05)。术后1、3、6个月,研究组的Harris髋关节功能量表评分均高于对照组,差异均有统计学意义(P<0.05)。研究组的并发症发生率为6.67%,低于对照组的26.67%,差异有统计学意义(P<0.05)。结论:相较于AFHR,老年不稳定型股骨粗隆间骨折患者采用PFNA治疗,在手术效果、术后康复进程、应激反应控制、髋关节功能恢复及并发症管理方面均展现出一定优势。Objective:To compare the efficacy of proximal femoral nail antirotation(PFNA)and artificial femoral head replacement(AFHR)in the treatment of senile unstable intertrochanteric femoral fractures.Methods:Data of 60 elderly patients with unstable intertrochanteric femoral fractures who received surgical treatment in Junan Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were retrospective analyzed,and were divided into a control group and a study group according to different surgical methods,with 30 cases in each group.The control group received AFHR treatment and the study group received PFNA treatment.The indexes of operation and postoperative rehabilitation,stress response levels,hip function and occurrence of complications were compared between the two groups.Results:The intraoperative blood loss of the study group was less than that of the control group,and the operation time,the first time of getting out of bed after surgery and the length of hospital stay were shorter than those of the control group,the differences were statistically significant(P<0.05).After operation,the levels of cortisol,epinephrine and norepinephrine in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).At 1,3 and 6 months after operation,the Harris Hip Scores of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).The incidence of complications in the study group was 6.67%,which was lower than 26.67%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with AFHR,PFNA treatment in elderly patients with unstable intertrochanteric femoral fractures shows certain advantage in terms of surgical outcome,postoperative rehabilitation,stress response control,hip function recovery and complication management.

关 键 词：不稳定型股骨粗隆间骨折 人工股骨头置换 股骨近端防旋髓内钉 手术效果 并发症 

分 类 号：R687.3[医药卫生—骨科学]