摘要
目的观察利赛膦酸钠对老年骨质疏松性股骨转子间骨折患者骨折愈合的影响。方法回顾性病例对照研究2019年6月至2020年6月经我院确诊的符合标准的老年股骨转子间骨折并行股骨近端防旋髓内钉利赛膦酸钠组(PFNA)内固定治疗后规律随访1年的患者。依据患者住院期间是否服用利塞膦酸钠,将患者分成利赛膦酸钠组(PFNA治疗联合应用利塞膦酸钠)和对照组(单纯PFNA治疗),利塞膦酸钠组39例,对照组44例。两组患者分别比较术前及术后1年骨密度值。采用Harris评分评价髋关节功能,RUSH评分评估骨折愈合情况,记录手术相关并发症、药物不良反应及其他部位骨折等情况。结果术后12个月复查时,所有患者骨折均愈合。利塞膦酸钠组和对照组术后1年健侧髋部平均骨密度T值分别为(-2.83±0.46和-3.16±0.42,t=-3.397,P=0.001);两组随访期间均无再发骨折;83例患者中利塞膦酸钠组患者39例,未出现明显的不良反应;对照组患者44例,其中1例患者出现较明显的消化道症状,表现为上腹部疼痛不适,伴恶心、食欲缺乏,停药后症状自行好转。结论骨质疏松性粗隆间骨折术后早期服用利塞膦酸钠不影响骨折愈合,并可提高健侧髋部骨密度。
Objective To observe the effect of Risedronate on fracture healing in elderly patients with osteoporotic femoral intertrochanteric fracture.Methods A retrospective case-control study was conducted on elderly patients with osteoporotic femoral intertrochanteric fractures in our hospital from June 2019 to June 2020.They were followed up regularly for 1 year after proximal femoral nail anti-rotation(PFNA)internal fixation.According to whether the patients took Risedronate during hospitalization,the patients were divided into two groups(PFNA internal fixation combined with Risedronate,39 cases)and control group(PFNA internal fixation alone,44 cases).The BMD values before and 1 year after operation were compared between the two groups.Harris score was used to evaluate hip function,Rush score was used to evaluate fracture healing,and the operation-related complications,adverse drug reactions and fractures in other parts were recorded.Results The fractures of all patients healed 12 months after operation.There were no recurrent fractures in both groups during follow-up.The mean bone mineral density(BMD)T value in healthy side hip was(-2.83±0.46)in Risedronate group and(-3.16±0.42)in control group(t=-3.397,P=0.001).Among the total 83 patients,39 patients in the Risedronate group had no obvious adverse reactions;1 patient of 44 patients in the control group had obvious upper abdominal pain and discomfort,accompanied by nausea and lack of appetite.These symptoms improved after stopping the drug.Conclusions Risedronate taken early after surgery does not affect fracture healing and can improve bone mineral density of healthy side hip.
作者
廖乐乐
杨张欢
倪江东
何桄旭
Liao Lele;Yang Zhanghuan;Ni Jiangdong;He Guangxu(Department of Orthopedics,The Second Xiangya Hospital,Central South University,Hunan 410011,China;Xiangya Cancer Center,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2022年第7期772-775,共4页
Chinese Journal of Geriatrics
基金
湖南省杰出青年基金(2018JJ10446)
中国国家自然科学基金青年项目(81802207)
中南大学湘雅名医基金的资助。
关键词
骨质疏松
膦酸类
股骨骨折
骨折愈合
Osteoporosis
Phosphonic acids
Femoral fractures
Fracture healing
