摘要
目的比较防旋髓内钉(PFNA)及动力髋螺钉(DHS)治疗股骨转子间骨折的临床疗效。方法 2013年1月—2015年12月成都医学院第一附属医院骨科收治股骨转子间骨折患者156例,其中男性88例,女性68例;年龄41~72岁,平均54.63岁。依据治疗方法分为PFNA组与DHS组,各78例,DHS组行DHS治疗,PFNA组行PFNA治疗。观察两组术中出血量、切口长度、手术时间、下床时间、引流量、骨折愈合时间等手术相关指标;术前及术后7d血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子(TNF-α)、白细胞介素-18(IL-18)等炎性因子;5-羟色胺(5-HT)、P物质(SP)、多巴胺(DA)、前列腺素E2(PGE2)、去甲肾上腺素(NE)等疼痛因子水平;术后1、6、12个月髋关节功能及术后并发症。结果 PFNA组术中出血量、切口长度、手术时间、下床时间、引流量、骨折愈合时间等手术相关指标均小于DHS组(P<0.05)。术后7d,PFNA组IL-6、IL-1β、TNF-α、IL-18及5-HT、SP、DA、PGE2、NE均低于DHS组(P<0.05)。PFNA组术后1、6、12个月Harris评分均高于DHS组(P<0.05)。PFNA组术后并发症发生率(2.56%)低于DHS组(12.82%,P<0.05)。结论 PFNA治疗股骨转子间骨折可改善髋关节功能,减少疼痛因子及并发症,有利于患者康复。
Objective To compare the clinical curative effect of intramedullary nail and dynamic hip screw for the treatment of intertrochanteric fracture （IF）. Methods A total of 156 IF patients admitted to our hospital from Jan. 2013 to Dec. 2015 were included in the PFNA group（ n =78） and DHS group（ n =78）,DHS group was treated with DHS,and PFNA group was treated with PFNA. Among them,88 were male and 68 were female,with age of 41-72（54.63 on average） years.The bleeding volume,incision length,operation time,bed time,drainage volume and fracture healing time in the two groups were observed. Inflammatory factors such as serum interleukin-6（IL-6）,interleukin-1β（IL-1β）,tumor necrosis factor-α（TNF-α）, interleukin-18 （IL-18）,pain factor levels such as 5-hydroxytryptamine（5-HT）,substance P（SP）,dopamine（DA）,prostaglandin E2（PGE2）,norepinephrine（NE）,and hip joint function and postoperative complications at 1,6 and 12 months after operation were observed. Results The blood loss,incision length,operation time,out-of-bed time,drainage volume and fracture healing time in PFNA group were all less than those in DHS group （ P 〈0.05 ）.At 7 days after operation,levels of IL-6,IL-1β,TNF-α,IL-18 and 5-HT,SP,DA,PGE2,NE in PFNA group were lower than those in DHS group （ P 〈0.05）.Harris score in PFNA group was higher than that in DHS group at 1,6 and 12 months after operation （ P 〈0.05）. The incidence of postoperative complications in PFNA group（2.56%） was lower than that in DHS group（12.82%, P 〈0.05）. Conclusion PFNA for the treatment of intertrochanteric fracture can improve hip joint function,reduce pain factors and complications,and is conducive for the recovery of patients.
作者
向登
林炎水
XIANG Deng,LIN Yan-shui(Department of Orthopedics,First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,Chin)
出处
《创伤外科杂志》
2018年第8期579-582,共4页
Journal of Traumatic Surgery
关键词
股骨转子间骨折
髓内钉
螺钉
疗效
femoral intertrochanteric fracture
intramedullary nail
screw
curative effect
