股骨重建髓内钉治疗股骨转子下骨折患者的疗效及稳定性  

Efficacy and Stability of Femoral Reconstruction Intramedullary Nail in the Treatment of Femoral Subtrochanteric Fracture

作　　者：温文伟 张时兴 杨毅诚 WEN Wenwei;ZHANG Shixing;YANG Yicheng(Department of Orthopedics,Sanming First Hospital,Sanming Fujian 365001,China)

机构地区：[1]三明市第一医院骨科,福建三明365001

出　　处：《中国卫生标准管理》2025年第4期132-135,共4页China Health Standard Management

摘　　要：目的 探讨股骨重建髓内钉治疗股骨转子下骨折患者的疗效及稳定性。方法 选取三明市第一医院2021年1月—2023年3月收治的80例股骨转子下骨折患者,随机分为对照组和试验组,各40例。对照组采用钢板固定治疗,试验组采用股骨重建髓内钉治疗。对比2组患者的失血量和治疗前后疼痛评分、Harris评分、生活质量评分、改良Barthel指数改善情况以及并发症例数、切口长度、满意度、首次下床活动时间、手术时间、平均骨折愈合时间、下地负重时间、住院时间。结果 治疗前,试验组疼痛评分为(7.51±1.08)分,Harris评分为(44.65±4.92)分,生活质量评分为(51.72±4.08)分改良Barthel指数为(33.42±2.22分);对照组疼痛评分为(7.67±1.02)分,Harris评分为(45.24±4.53)分,生活质量评分为(51.91±4.34)分,改良Barthel指数为(33.69±2.58)分,2组对比,差异无统计学意义(P> 0.05)。治疗后,试验组疼痛评分为(1.55±0.42)分,Harris评分为(79.59±6.25)分,生活质量评分为(92.59±4.52)分,改良Barthel指数为(86.11±5.47)分,对照组疼痛评分为(2.75±0.89)分,Harris评分为(64.41±5.38)分,生活质量评分为(82.36±3.29)分,改良Barthel指数为(73.05±4.56)分,2组均改善,且试验组优于对照组,差异有统计学意义(P <0.05)。试验组骨折患者并发症率(2.50%)低于对照组(15.00%),差异有统计学意义(P=0.034)。对照组手术时间为(93.28±6.77)min,平均骨折愈合时间为(18.39±3.87)周,切口长度为(7.39±1.64)cm,下地负重时间为(5.68±0.79)周,首次下床活动时间为(36.58±4.48)d,失血量为(196.52±13.15)m L,平均住院时间为(17.26±3.61)d;试验组手术时间为(81.44±5.25)min,平均骨折愈合时间为(16.41±2.08)周,切口长度为(6.17±1.21)cm,下地负重时间为(4.25±0.66)周,首次下床活动时间为(15.31±2.64)d,失血量为(162.08±10.34)m L,平均住院时间为(10.74±2.39)d,差异有统计学意义(P <0.05)。试验组患者总满意率(95.00%)高于对�Objective To analyze the efficacy and stability of femoral reconstruction with intramedullary nail in the treatment of femoral subtrochanteric fracture. Methods A total of 80 patients with subtrochanteric fracture of femur admitted to the Sanming First Hospital from January 2021 to March 2023 were randomly divided into control group and experimental group, with 40 patients in each group. The control group was treated with plate fixation, and the experimental group was treated with femoral reconstruction intramedullary nail. Blood loss, pain score before and after treatment, Harris score, quality of life score, improvement of modified Barthel index, number of complications, incision length, satisfaction, first time of getting out of bed, operation time, mean time of fracture healing, time of carrying weight under the ground, and length of hospital stay were compared between the two groups. Results Before treatment, the pain score of the experimental group was (7.51±1.08) points, Harris score was (44.65±4.92) points, quality of life score was (51.72±4.08) points, and the modified Barthel index was (33.42±2.22) points, the pain score of the control group was (7.67±1.02) points, Harris score was (45.24±4.53) points, quality of life score was (51.91±4.34) points, and the modified Barthel index was (33.69±2.58) points, there was no statistically significant difference between the two groups (P > 0.05). After treatment, the pain score of the experimental group was (1.55±0.42) points, Harris score was (79.59±6.25) points, quality of life score was (92.59±4.52) points, and the modified Barthel index was (86.11±5.47) points, the pain score of the control group was (2.75±0.89) points, Harris score was (64.41±5.38) points, quality of life score was (82.36±3.29) points, and the modified Barthel index was (73.05±4.56), the differences were statistically significant (P < 0.05). The complication rate of fracture patients in the experimental group (2.50%) was lower than that in the control group (15.00%), and the

关 键 词：股骨重建髓内钉 钢板固定 股骨转子下骨折 改良BARTHEL指数 疗效 稳定性 

分 类 号：R459[医药卫生—治疗学]