PFNA与外固定支架治疗老年股骨粗隆间骨折疗效的对比分析

发布时间：2018-10-23 07:03

【摘要】：目的:通过两种手术方式—PFNA和外固定支架—治疗老年股骨粗隆间骨折,客观分析两种手术方式的临床疗效,探讨两种手术方法各自的特点,为临床选用合适手术方法治疗老年股骨粗隆间骨折提供参考。方法:通过系统回顾,收集佛山市中医院骨七科自2013年4月至2014年11月间住院治疗的符合纳入标准的老年股骨粗隆间骨折患者病例74例,其中34例采用PFNA治疗,40例采用外固定架治疗。对两组患者的手术操作时间(分钟)、术中出血量(毫升)、住院时间(天)、骨折临床愈合时间(周)、并发症情况进行分析观察,并作统计学分析。结果:外固定支架和PFNA在手术时间(35.20±5.11vs42.79±4.66分钟)、术中出血量(4.95±1.06vs122.35±12.81毫升)、住院时间(8.07±2.15vs11.38±2.57天)、术后并发症等方面比较差异均有统计学意义(P0.05),外固定支架手术时间短、出血少、住院时间短,两组在骨折临床愈合时间(11.00±1.24vs10.68±1.57周)无明显差别(P0.05);术后并发症方面PFNA组优于外固定支架组。术后半年髋关节创伤后Harriss评分两组对比无明显差异(P0.05)。结论:PFNA和外固定支架在治疗老年股骨粗隆间骨折方面均能取得不错效果。外固定支架具有操作简便、创伤小、出血少、尤其适合伴严重内科疾病、手术耐受性差的老年人。虽然存在膝关节僵硬、针道感染等并发症,但一般经治疗后基本能恢复,是目前治疗老年股骨粗隆间骨折的一种很好的方法,值得临床推广使用。
[Abstract]:Objective: to treat intertrochanteric fracture of the aged femur by PFNA and external fixation stents, and to analyze the clinical effect of the two surgical methods objectively, and to explore the characteristics of the two surgical methods. To provide a reference for the treatment of intertrochanteric fracture of femur. Methods: through systematic review, 74 elderly patients with intertrochanteric fracture of femur, who were hospitalized from April 2013 to November 2014 in Department of Bone of Foshan traditional Chinese Medicine Hospital, were collected. 34 cases were treated with PFNA and 40 cases with external fixator. The operative time (min), intraoperative bleeding volume (ml), hospitalization time (day), fracture healing time (week) and complications of the two groups were analyzed and analyzed. Results: there were significant differences in operative time (35.20 卤5.11vs42.79 卤4.66 minutes), intraoperative bleeding volume (4.95 卤1.06vs122.35 卤12.81 ml), hospitalization time (8.07 卤2.15vs11.38 卤2.57 days) and postoperative complications between external fixation stent and PFNA (P0.05). There was no significant difference in fracture healing time (11.00 卤1.24vs10.68 卤1.57 weeks) between the two groups (P0.05). The postoperative complications in PFNA group were better than those in external fixation stent group. There was no significant difference in Harriss score between the two groups half a year after operation (P0.05). Conclusion: PFNA and external fixator are effective in the treatment of intertrochanteric fracture. External fixator is easy to operate, less trauma, less bleeding, especially suitable for the elderly with severe internal diseases and poor surgical tolerance. Although there are complications such as knee joint stiffness and needle infection, it can recover after treatment. It is a good method for the treatment of intertrochanteric fracture of the femur in the elderly, and it is worth popularizing in clinic.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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