摘要
目的:研究观察股骨近端防旋髓内钉(proximal femoral nail antirotation,PFNA)在高龄不稳定型股骨转子间骨折患者中的临床疗效与对创伤应激程度的影响。方法:选取2016年2月-2019年10月本院收治的87例高龄不稳定型股骨转子间骨折患者作为研究对象,根据治疗方式分为对照组23例和观察组64例,对照组采用动力髋螺钉(dynamic hip screw,DHS)治疗,观察组采用PFNA治疗。比较两组切口长度、手术时间、出血量、术后不同时间Harris评分、手术前后创伤应激程度指标(应激激素与炎性反应)水平。结果:观察组切口长度、手术时间短于对照组,出血量显著少于对照组,差异均有统计学意义(P<0.05)。观察组术后3、6个月Harris评分优良率均显著高于对照组,差异均有统计学意义(P<0.05)。两组术前创伤应激程度指标比较,差异均无统计学意义(P>0.05);观察组术后1、3 d创伤应激程度指标均低于对照组,差异均有统计学意义(P<0.05)。结论:FNA在高龄不稳定型股骨转子间骨折患者中的临床疗效较好,且对创伤应激程度的控制相对较好,应用价值较高。
Objective:To study and observe the clinical effect of elderly patients with PFNA on unstable intertrochanteric fracture and influence on the degree of traumatic stress.Method:A total of 87 elderly patients with unstable intertrochanteric fracture treated in our hospital from February 2016 to October 2019 were selected as the research objects.According to the treatment methods,they were divided into the control group (23 cases) and the observation group (64 cases).The control group was treated with dynamic hip screw (DHS),while the observation group was treated with PFNA.Then the incision length,operation time,blood loss,Harris score at different time of postoperative,traumatic stress indexes (stress hormones and inflammatory responses) of two groups before and after operation were compared.Result:The incision length and operation time of the observation group were shorter than those of the control group,the blood loss was significantly less than that of the control group,there were statistically significant differences (P<0.05).At 3 and 6 months after operation,the excellent and good Harris score rate were significantly higher than those of the control group,there were statistically significant differences (P<0.05).There were no significant differences in the degree of traumatic stress between two groups before operation (P>0.05).At 1 and 3 d after operation the traumatic stress indexes in the observation group were lower than those in the control group,and the differences were statistically significant (P<0.05).Conclusion:FNA has a good clinical effect in elderly patients with unstable intertrochanteric fracture,has a relatively good control of the degree of traumatic stress,it has a high application value.
作者
陈忠益
曾国庆
黄建军
CHEN Zhongyi;ZENG Guoqing;HUANG Jianjun(Haicang Hospital,Xiamen 361026,China)
出处
《中国医学创新》
CAS
2020年第31期22-25,共4页
Medical Innovation of China
关键词
PFNA
高龄患者
不稳定型股骨转子间骨折
创伤应激
Proximal femoral nail antirotation
Elderly patients
Unstable intertrochanteric fracture
Traumatic stress
