骨质疏松性股骨粗隆间骨折的手术方式比较

发布时间：2018-01-28 18:13

本文关键词： 骨质疏松股骨粗隆间骨折股骨近端髓内钉内固定人工髋关节置换　出处：《中国骨质疏松杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的比较分析股骨近端髓内钉内固定(proximal femoral nail-rotation,PFNA)和人工髋关节置换术(hip arthroplasty,HA)治疗骨质疏松性粗隆间骨折的临床疗效。方法回顾性分析2013年1月至2015年12月在我院骨科治疗的73例骨质疏松性老年股骨粗隆间骨折患者,按照手术方法不同分为PFNA组39例和HA组34例,比较两组患者的手术操作时间、术中出血量、住院时间、术后下地时间等指标以及术后12月髋关节功能Harris评分与并发症发生情况。结果 PFNA组的术中出血量(116.89±23.12 mL)、手术操作时间(75.36±14.18 min)明显少于HA组(362.57±136.41 mL,97.85±19.76 min),而术后下地时间(17.38±2.13 d)明显长于HA组(8.65±1.63 d),差异均有统计学意义(t=-4.863,-2.532,9.914;P=0.001,0.030,0.000)。Harris评分结果显示,两组患者术后髋关节功能优良率无明显差异(χ~2=0.562,P=0.454)。两组患者术后12个月的并发症发生情况无明显差异(Z=4.037,P=0.372)。结论 PFNA内固定术治疗骨质疏松性股骨粗隆间骨折在缩短手术时间、控制出血量方面优势明显,HA术后下地时间较短,更利于患者恢复。临床医生应当根据患者在年龄、身体状况、骨折类型、损伤程度等情况选择适合的治疗方案。
[Abstract]:Objective to compare and analyze proximal femoral nail-rotation of proximal femoral intramedullary nail. PFNA) and hip arthroplasty for hip arthroplasty. Ha). Methods from January 2013 to December 2015, 73 patients with osteoporotic intertrochanteric fracture of femur were treated in our hospital from January 2013 to December 2015. According to the different operation methods, 39 cases in PFNA group and 34 cases in HA group were divided into two groups. The operative time, intraoperative bleeding volume and hospitalization time were compared between the two groups. Harris score of hip function and complications occurred on December. Results the intraoperative bleeding volume in PFNA group was 116.89 卤23.12mL). The operative time was 75.36 卤14.18 min, which was significantly less than that in HA group (362.57 卤136.41 mL / L, 97.85 卤19.76 min). However, the time after operation was 17.38 卤2.13 days longer than that in HA group (8.65 卤1.63 d), and the difference was statistically significant (P < 0.05). 9.914; The results of P0. 001, 0. 030 and 0. 000 Harris score showed that there was no significant difference in the excellent and good rate of hip joint function between the two groups after operation (蠂 2 0. 562). There was no significant difference in the incidence of complications 12 months after operation between the two groups. Conclusion PFNA internal fixation in the treatment of osteoporotic intertrochanteric fracture of femur can shorten the operative time and control the amount of blood loss. The clinician should choose the appropriate treatment plan according to the patient's age, physical condition, fracture type, injury degree and so on.
【作者单位】：许昌仁和骨科医院脊柱关节科;无锡市中国人民解放军第101医院外科7楼骨科二区;
【分类号】：R687.3;R580
【正文快照】： 股骨粗隆间骨折在老年人中有较高的发生率,主要原因是老年人骨质疏松,在跌倒时下肢突然扭转或过度收敛、外展,以及外力冲击大粗隆造成。目前手术治疗是治愈股骨粗隆间骨折的最有效治疗方法,目的是早日恢复患者的髋关节功能,减少并发症发生,提高患者的生活质量。但老年人由于器

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