摘要
目的:探讨不同手术治疗高龄股骨粗隆间骨折对患者髋关节功能及术后恢复的影响。方法:根据手术方式的不同将86例高龄股骨粗隆间骨折患者分为采用内固定(股骨近端防旋髓内钉)治疗的A组和采用人工股骨头置换术治疗的B组,每组各43例。比较两组住院时间、切口长度、手术时间、卧床时间、术中出血、骨折愈合时间、并发症发生情况、炎症反应、骨代谢指标、疼痛、髋关节功能及生活能力。结果:B组切口长度、手术时间及术中出血量均高于A组,但住院时间、卧床时间及骨折愈合时间均短于A组(P<0.05)。术后3个月,两组血清肿瘤坏死因子α(TNF-α)、白细胞介素10(IL-10)、IL-6、抗酒石酸酸性磷酸酶5b(TRACP-5b)、β-异构c端端肽(β-CTx)与术前比较均降低(P<0.05),且B组低于A组(P<0.05);血清Ⅰ型前胶原氨基端原肽(PINP)均升高,且B组高于A组(P<0.05)。术后6、12个月,两组疼痛评分均呈降低趋势(P<0.05),且B组于术后1个月低于A组(P<0.05);髋关节功能、生活能力评分呈升高趋势,且观察组在术后1、6个月时高于对照组(P<0.05)。观察期间,两组总并发症发生率比较,差异无统计学意义(P>0.05)。结论:人工股骨头置换术治疗高龄股骨粗隆间骨折,患者术后恢复更快,炎症、骨代谢及术后疼痛情况更好,有利于髋关节、生活能力恢复。
Objective:To explore the effects of different surgical treatments on hip joint function and postoperative recovery in elderly patients with intertrochanteric fracture.Methods:According to different surgical methods,86 elderly patients with intertrochanteric fracture of femur were divided into 1 group treated with internal fixation(proximal femoral antirotation intramedullary nail)and 2 group treated with artificial femoral head replacement,with 43 cases in each group.The hospital stay,incision length,operation time,bed rest time,intraoperative bleeding,fracture healing time,complications,inflammatory reaction,bone metabolism index,pain,hip function and living ability were compared between the two groups.Results:The length of incisions,surgical time,and intraoperative bleeding in the groups 2 were higher than those in group 1,but the hospital stay,bed rest time,and fracture healing time were shorter than those in group 1(P<0.05).The serum serum tumor necrosis factorα(TNF-α),Interleukin-10(IL-10),Interleukin-6(IL-6),tartrate resistant acid phosphatase 5b(TRACP-5b),andβ-Isomeric C-terminal peptide(β-CTX)in two groups were lower than before surgery 3 months after surgery,the decrease in group 2 was lower than that in group 1(P<0.05).The serum type I procollagen amino terminal peptide(PINP)was higher than that before,and the group 2 was higher than group 1(P<0.05).At 6 and 12 months after operation,the score of pain of both groups showed a decreasing trend,1month after surgery,the pain score of group 2 was lower than that of group 1(P<0.05).The hip function and life ability scores of both groups showed an increasing trend(P<0.05).At 1 and 6 months after surgery,hip function and life ability scores in the group 2 were higher than those in group 1(P<0.05).During the observation period,there was no statistical difference in the incidence of total complications between the two groups(P>0.05).Conclusion:Artificial femoral head replacement in the treatment of elderly intertrochanteric fracture of femur,the postoperative
作者
李祎
李奎蒙
郑海
LI Yi;LI Qui-meng;ZHENG Hai(Department of Orthopedics,the First Hospital of Zhangjiakou,Zhangjiakou 075000,Hebei,China)
出处
《川北医学院学报》
CAS
2024年第4期461-464,共4页
Journal of North Sichuan Medical College
基金
河北省卫生健康委医学科学研究课题计划项目(20221901)。
关键词
股骨粗隆间骨折
高龄
置换
髓内钉
内固定
髋关节功能
Intertrochanteric fracture of femur
Old age
Substitution
Intramedullary nail
Internal fixation
Hip function
