不同时机行股骨近端防旋髓内钉内固定治疗老年股骨转子间骨折的效果比较  

Comparison of the efficacy of proximal femoral nail anti-rotation internal fixation therapy at different time on aged intertrochanteric fracture of femur

作　　者：穆杰[1] 徐永申[1] 李友涛[1] Mu Jie;Xu Yongshen;Li Youtao(The Second Ward,Department of Orthopedics,the Second Afiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第二附属医院骨科二病区,河南洛阳471000

出　　处：《临床医学》2025年第3期16-18,共3页Clinical Medicine

基　　金：河南省科技计划联合共建项目(LHGJ20220700)。

摘　　要：目的 比较不同时机行股骨近端防旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折的疗效。方法 选取2021年8月至2022年6月河南科技大学第二附属医院收治的112例老年股骨转子间骨折患者为研究对象,均行PFNA内固定治疗,同时根据手术时机差异分为两组。研究组50例采用早期手术治疗,即骨折后48 h内手术治疗;对照组62例采用延期手术治疗,即骨折后48 h后手术治疗,比较两组手术时间、术中出血量、骨折愈合时间、术后住院时间、并发症、炎性指标、髋关节功能及生活质量评分。结果 研究组手术时间、术中出血量、骨折愈合时间、术后住院时间均较对照组低(P<0.05)。术后研究组总并发症发生率显著较对照组低(P<0.05)。术后两组炎性指标均较术前升高,且对照组更高(P<0.05)。术后两组的髋关节功能及生活质量评分均较术前升高,且研究组更高(P<0.05)。结论 早期PFNA治疗老年股骨转子间骨折的疗效较佳,同时安全性较高且可减轻手术应激反应程度,最终改善患者预后。Objective To compare the efficacy of proximal femoral nail anti-rotation(PFNA)internal fixation therapy at different time on aged intertrochanteric fracture of femur.Methods A total of 112 elderly patients with intertrochanteric fracture of femur admitted to the Second Affiliated Hospital of Henan University of Science and Technology from August 2021 to June 2022 were selected as the study objects,all of whom received PFNA internal fixation treatment,and were divided into two groups according to the difference in operation timing.In the study group,50 cases were treated with early operation,that is,within 48 h after fracture.In the control group,62 patients were treated with delayed operation,that is,48 h after fracture.The operation time,intraoperative blood loss,fracture healing time,postoperative hospitalization time,complication,inflammatory indexes,hip function and quality of life scores of the two groups were compared.Results The operation time,blood loss fracture healing time,postoperative hospitalization time in the study group were lower than those in the control group(P<0.05).The total complication rate of the study group was significantly lower than that of the control group(P<0.05).After operation,the inflammatory indexes in both groups were higher than those before operation,and more higher in the control group(P<O.05).Hip function and quality of life scores in both groups were higher than those before surgery,and more higher in the study group(P<0.05).Conclusions Early PFNA treatment of intertrochanteric fracture in the elderly has better efficacy,which is safer and can reduce the degree of surgical stress,and ultimately improves the prognosis of the patients.

关 键 词：不同手术时机 股骨近端防旋髓内钉 内固定 股骨转子间骨折 老年 疗效 

分 类 号：R687.3[医药卫生—骨科学]