摘要
目的：探讨防旋股骨近端髓内钉（PFNA）治疗骨质疏松性股骨粗隆间骨折患者围术期的护理方法。方法：对48例骨质疏松性股骨粗隆间骨折患者采用闭合复位PFNA微创内固定，手术前后予以科学的护理配合和康复指导。结果：本组患者住院时间为7—14d，平均10d。术后46例患者随访5～18个月，1例术后2个月因脑血管意外死亡，1例术后3个月因胃癌全身转移死亡；均未发现骨不连、髋内翻畸形、内固定断裂、股骨干骨折、股骨头切割等并发症；采用Harris评分评定术后髋关节功能：优25例（52．1％），良15例（31．2％），一般6例（12．5％），差2例（4．2％）。结论：PFNA治疗骨质疏松性股骨粗隆间骨折具有创伤小、内固定坚强、能早期功能锻炼、并发症少等优点，加强围术期护理可提高手术成功率。
Objective： To explore the perioperative nursing methods in the treatment of patients with osteoporotie intertrochanteric fracture by using anti - rotation proximal femoral nail. Methods ： 48 patients with osteoporotie intertroehanterie fractures were treated with closed reduction and minimally invasive internal fixation with anti - rotation proximal femoral nail, scientific nursing care and rehabilitation guidance were given to the patients before and after operation. Results： The hospitalization time was 7 to 14 days, averagely 10 days in this group. 46 patients were followed up for 5 to 18 months after operation, one patient died of cerebrovaseular accident 2 months later and another one died due to systemic metastasis of gastric cancer 3 months later. But no nonunion, coxa vara deformity, fixation broken, femoral shaft fractures, femoral cut and other complications were found in the patients. Hip joint function of the patients was postoperatively assessed using Harris scoring scale. Excellent in 25 eases （52.1% ）, good in 15 eases （31.2% ）, fair in 6 eases （ 12.5% ） and poor in 2 cases （4.2% ）. Conclusion： Minimally invasive internal fixation with anti - rotation proximal femoral nail has the advantages of fewer traumas, firm fixation and fewer complications , etc. in the treatment of osteoporotic intertroehanteric fractures. Enhanced perioperative nursing care can improve the success rate of surgery.
关键词
骨质疏松性股骨粗隆间骨折
防旋股骨近端髓内钉
围术期护理
Osteoporotie intertroehanteric fractures
Anti -rotation proximal femoral nail
Perioperative nursing
