摘要
目的探讨体质量指数(BMI)对股骨近端防旋型髓内钉(PFNA)治疗高龄股骨转子间骨折患者临床疗效的影响。方法回顾性分析2015年4月到2016年4月广东省江门市五邑中医院(暨南大学附属江门中医院)骨伤科二区采用PFNA治疗股骨转子间骨折患者68例的临床资料,根据BMI值将这些患者分为肥胖组(BMI≥25.0 kg/m^2)31例和非肥胖组(BMI<25.0 kg/m^2)37例。比较两组患者的围手术期失血量、疼痛、术后负重时间、术后疗效、住院时间、骨折愈合时间以及并发症发生情况。结果68例患者均顺利完成手术,住院期间无死亡病例,无肺栓塞。所有患者均获12~24个月随访,平均随访时间(18.3±2.4)个月。肥胖组的围手术期总失血量(1057±87)m L,显著高于非肥胖组(863±69)m L,差异有统计学意义(t=17.357,P<0.05)。肥胖组Harris评分为(78.4±3.1)分,优良率为75.6%;非肥胖组为(86.1±3.2)分,优良率为90.3%,评分差异有统计学意义(U=3.215,P<0.05)。肥胖组术后并发症发生率为12.9%(4/31),非肥胖组术后并发症发生率为8.1%(3/37),两组患者比较无统计学差异(χ~2=4.470,P>0.05)。肥胖组开始负重时间为(35±3)d,晚于非肥胖组(18.7±1.5)d,差异具有统计学意义(t=8.928,P<0.05)。两组术后VAS评分比较,差异无统计学意义。结论股骨近端防旋型髓内钉内固定术是治疗股骨转子间骨折一种较好手术方法,体质量指数对高龄股骨转子间骨折PFNA内固定术后疗效的影响在于肥胖人群术后疗效略差于非肥胖人群。
Objective To study of the body mass index on post operative outcome in elderly patients with intertrochanteric fractures with PFNA fixation.Methods The data of68elderly patients with intertrochanteric fractures,who received treatment from April2015to April2016in the second Department of Orthopaedic Wuyi TCM Hospital of Jiangmen Guangdong(the Jiangmen TCM Affiliated Hospital of Ji'nan University)and had complete follow-up data were analyzed restrospectively.According to BMI classification standard,all the patients were divided into2groups:31patients in obesity group(BMI≥25.0kg/m2)and37patients in non-obese group(BMI<25.0kg/m2).Perioperative blood loss,pain,postoperative weight-bearing time,postoperative efficacy,hospital stay,fracture healing time and complication were compared between the two groups.Results All68patients completed the operation without death or pulmonary embolism.All patients were followed up for12to24months,with an average follow-up time(18.3plus or minus2.4)months.The total blood loss(1057±87)mL in the perioperative period of the obese group was significantly higher than that in the non-obese group(863±69)mL,and the difference was statistically significant(t=17.357,P<0.05).The Harris score of the obese group was78.4plus or minus3.1,and the optimal rate was75.6%.In the non-obese group(86.1±3.2),the optimal rate was90.3%,and the score difference was statistically significant(U=3.215,P<0.05).The incidence of postoperative complications was12.9%(4/31),significantly higher than the non-obese group8.1%(3/37,χ2=4.470,P<0.05).The obese group began to load time(35±3)d,and later in the non-obese group(9.7±1.5)d,the difference was statistically significant(t=8.928,P<0.05).There was no statistically significant difference between the two groups.Conclusion PFNA is reliable for Intertrochanteric fracture,the posto perative effect of obese people was slightly worse than that of non-obese people.
作者
陈述祥
刘彦
区文欢
陈丽君
Chen Shuxiang;Liu Yan;Ou Wenhuan;Chen Lijun(The second Department of orthopedic,the Jiangmen TCM Affiliated Hospital of Ji'nan University (Wuyi TCM Hospital of Jiangmen )Guangdong,Jiangmen, 529031, China;Rehabilitation Department, the Jiangmen TCM Affiliated Hospital of Ji'nan University (Wuyi TCM Hospital of Jiangmen )Guangdong,Jiangmen, 529031, China)
出处
《中华肥胖与代谢病电子杂志》
2017年第3期138-142,共5页
Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition
基金
江门市科技计划项目[2014]73-6号
