摘要
目的比较股骨近端防旋髓内钉(PFNA)和动力髋螺钉(DHS)内固定治疗股骨转子间骨折的临床疗效及围术期失血量。方法选择股骨转子间骨折患者54例,根据手术治疗方法不同分为PFNA组28例和DHS组26例,观察两组患者手术时间、失血量(术中失血量、术后总引流量及隐性失血量)、骨折愈合时间、髋关节功能及并发症等。结果 PFNA组手术时间(66.1±7.4)min,DHS组手术时间(85.6±9.2)min;PFNA组骨折愈合时间(10.5±2.1)周,DHS组骨折愈合时间(13.8±2.5)周,组间比较差异有统计学意义(P<0.05)。术后6个月,PFNA组患者Harris评分明显优于DHS组,差异有统计学意义(P<0.05)。DHS组患者术中失血量、术后24 h显性失血量均明显高于PFNA组,而PFNA组患者术后24 h隐性失血量明显高于DHS组,差异有统计学意义(P<0.05)。PFNA组患者术后并发症发生率为10.7%,低于DHS组的30.8%,差异有统计学意义(P<0.05)。结论 PFNA内固定治疗股骨转子间骨折手术时间短、骨折愈合快、并发症少,但术后隐性失血量多,术后应严密监测生命体征。
Objective To compare the clinical efficacy and perioperative blood loss between proximal femoral anti-rota- tion intramedullary nail （PFNA） and dynamic hip screw （DHS） internal fixation in the treatment of femoral in- tertroehanteric fracture. Methods 54 patients with femoral intertrochanteric fractures were selected. According to differ- ent surgical treatments, the patients were divided into PFNA group of 28 cases and DHS group of 26 cases. The surgery time, blood loss （intraoperative blood loss, postoperative total drainage and hidden blood loss）, fracture healing time, hip function and complications were observed in both groups. Results The surgery time was （66.1±7.4） min in PFNA group, and the surgery time was （85.6±9.2） min in DHS group; the fracture healing time was （10.5±2.1） weeks in PFNA group, and the fracture healing time was （13.8±2.5） weeks in DHS group. The difference was statistically significant（P〈0.05）. At 6 months after the surgery, the Harris score in PFNA group was significantly higher than that in DHS group, and the difference was statistically significant（P〈0.05）. The intraoperative blood loss, and dominant blood loss 24 h after the surgery in DHS group were significantly higher than those in the PFNA group. The hidden blood loss 24 h after the surgery in the PFNA group was significantly higher than that in DHS group（P〈0.05）. The incidence of postoperative complications was 10.7% in the PFNA group and 30.8% in the DHS group, and the difference was statistically signifi- cant（P〈O.05）. Conclusion PFNA internal fixation in the treatment of intertrochanteric fractures of femur has short surgery time, faster fracture healing and less complications, but the amount of hidden blood loss after the surgery is much. The postoperative vital signs should be closely monitored.
出处
《中国现代医生》
2017年第23期66-68,72,共4页
China Modern Doctor
关键词
股骨转子间骨折
股骨近端防旋髓内钉
动力髋螺钉
失血量
Intertrochanteric fractures of femur
Proximal femoral anti-rotation intramedullary nail（PFNA）
Dynamichip screw （DHS）
Volume of blood loss
