摘要
目的:分析股骨近端防旋髓内钉(PFNA)或人工股骨头置换(HHA)治疗对老年不稳定股骨转子间骨折患者髋关节功能、日常生活能力量表(ADL)评分及后并发症的影响。方法:将本院2014年1月至2017年10月收治的94例老年不稳定股骨转子间骨折患者按手术方式分组,其中PFNA治疗50例,设A组,HHA治疗44例,设B组;比较两组髋关节功能、ADL评分及术后并发症。结果:A组手术时间、术中出血量及术后1个月、3个月时的Harris功能评分、术后3个月时的ADL评分均显著低于B组,术后卧床时间显著高于B组(P<0.05);但两组住院时间、术后1年时的Harris功能评分及术后6个月、术后1年时的ADL评分、并发症发生率比较差异均无统计意义(P>0.05)。结论:PFNA或HHA治疗老年不稳定股骨转子间骨折均可取得一定治疗获益,各有特点,临床或应依据患者实际情况综合考量。
Objective:To analyze the effects of proximal femoral nail antirotation and artificial femoral head arthrolasty on hip joint function,Ability of Daily Life(ADL)score and postoperative complications in elderly patients with unstable intertrochanteric femoral fracture.Methods:A total of 94 elderly patients with unstable intertrochanteric femoral fracture in the hospital from January 2014 to October 2017 were enrolled in this study.According to the surgical methods,50 patients treated with proximal femoral nail antirotation were included in group A.44 patients treated with artificial femoral head arthrolasty were included in group B.The operation condition,hip joint function,ADL score and postoperative complications were compared between the two groups.Results:The operation time,intraoperative blood loss,hip joint function scores at 1 month and 3 months after operation and ADL score at 3 months after operation in group A were significantly lower than those in group B,while postoperative rest time was significantly long than that ingroup B(P<0.05).There was no significant difference in length of stay,the hip joint function score at 1 year after surgery,the ADL score at 6 months and 1 year after surgery,incidence of complications between the two groups(P>0.05).Conclusion:Both proximal femoral nail antirotation and artificial femoral head arthrolasty are effective for the treatment of elderly patients with unstable intertrochanteric femoral fracture,and they all have their characteristics.Comprehensive consideration should be performed clinically according to the actual situation of patients.
作者
马春涛
谭昱
肖育志
陈立刚
郭良
MA Chuntao;TAN Yu;XIAO Yuzhi(Sanya Hospital of Traditional Chinese Medicine,Hainan Sanya 572000,China)
出处
《河北医学》
CAS
2019年第7期1098-1101,共4页
Hebei Medicine
基金
国家自然科学基金资助面上项目,(编号:81373669)
海南省卫生计生科研项目,(编号:16A200122)
关键词
股骨近端防旋髓内钉
人工股骨头置换
老年
不稳定股骨转子间骨折
Proximal femoral nail antirotation
Artificial femoral head arthrolasty
The elderly
Unstable intertrochanteric femoral fracture
