摘要
目的 分析股骨近端抗旋髓内钉术(proximal femoral nail antirotation,PFNA)治疗老年不稳定性股骨粗隆间骨折患者的手术效果及预后。方法 随机选取2020年1月—2023年1月淮安市中医院骨伤科收治的60例老年不稳定性股骨粗隆间骨折患者为研究对象,并以随机数表法分为股骨近端锁定钢板(locking proximal femoral bone plate,LPFP)组(27例)和PFNA组(33例),对比两组的治疗有效率、手术指标、术后并发症发生率及术后不同时间段的Harris评分、生活自理能力评分、生活质量评分。结果 LPFP组治疗有效率92.59%高于PFNA组的87.88%,但差异无统计学意义(χ^(2)=0.030,P>0.05)。两组患者手术时长、术中出血量比较,差异无统计学意义(P>0.05),但PFNA组患者的排气时间、肠蠕动时间、卧床时间、住院时间等手术指标均显著短于LPFP组,差异有统计学意义(P<0.05)。PFNA组患者的各项术后并发症总发生率显著低于LPFP组,差异有统计学意义(P<0.05)。PFNA组患者术后3、7 d的疼痛评分显著低于LPFP组,差异有统计学意义(P<0.05)。出院3个月时,PFNA组患者Harris、ADL及WHOQOL-100评分均显著高于LPFP组,差异有统计学意义(P<0.05)。结论 以PFNA术治疗老年不稳定性股骨粗隆间骨折患者可取得安全高效的理想手术效果,且预后效果较佳。
Objective To analyze the surgical effect and prognosis of proximal femoral nail anti-rotation(PFNA)in the treatment of elderly patients with unstable intertrochanteric fractures of the femur.Methods 60 elderly patients with unstable intertrochanteric fractures of the femur admitted to the Department of Orthopedics and Traumatology of Huai'an Traditional Chinese Medicine Hospital from January 2020 to January 2023 were randomly selected as the research subjects.They were randomly divided into a proximal locking proximal femoral bone plate(LPFP)group(27 cases)and a PFNA group(33 cases).The effective rate of treatment,operative index,postoperative complication rate,Harris score,self-care ability score and quality of life score in different postoperative periods were compared between the two groups.Results The effective rate of treatment in the LPFP group was 92.59%higher than that in the PFNA group,which was 87.88%,but the difference was not statistically significant(χ^(2)=0.030,P>0.05).There was no statistically significant difference in surgical duration and intraoperative bleeding between the two groups of patients(P>0.05),but the PFNA group had significantly shorter surgical indicators such as exhaust time,intestinal peristalsis time,bed rest time,and hospital stay compared to the LPFP group,the difference was statistically significant(P<0.05).The total incidence of postoperative complications in the PFNA group was significantly lower than that in the LPFP group,the difference was statistically significant(P<0.05).The pain scores of patients in the PFNA group at 3 and 7 days after surgery were significantly lower than those in the LPFP group,the difference was statistically significant(P<0.05).At 3 months after discharge,the Harris,ADL,and WHOQOL-100 scores of patients in the PFNA group were significantly higher than those in the LPFP group,the difference was statistically significant(P<0.05).Conclusion PFNA for unstable intertrochanteric fractures of the femur in the elderly can achieve safe and efficient surgi
作者
梁世晅
LIANG Shixuan(Department of Orthopedics and Traumatology,Huai'an Hospital of Traditional Chinese Medicine,Huai'an,Jiangsu Province,223001 China)
出处
《中外医疗》
2023年第20期22-26,共5页
China & Foreign Medical Treatment
关键词
老年不稳定性股骨粗隆间骨折
股骨近端抗旋髓内钉
股骨近端锁定钢板
Unstable intertrochanteric fractures of the femur
Proximal femoral nail
Proximal femoral locking compression plate
