防旋股骨近端髓内钉PFNA内固定微创治疗老年股骨粗隆间骨折的临床疗效评价(1)
[摘要] 目的 评价分析老年股骨粗隆间骨折采取防旋骨近端髓内钉固定微创治疗的临床价值。 方法 随机选取2016年3月—2019年1月该院收治的老年股骨粗隆间骨折患者共计88例，将其平均分为实验组与参照组，其中实验组44例患者接受防旋股骨近端髓内钉(PFNA)内固定微创治疗，对照组44例患者接受动力髋螺钉(DHS)固定术治疗方式，对比两组患者手术时间、出血量、不良反应发生率等情况。 结果 实验组的手术时间(52.2±6.1)min、愈合时间(12.4±1.6)周、出血量(173.4±66.1)mL优于参照组(69.7±8.3)min、(20.2±6.3)周、(297.9±44.4)mL，组间差异有统计学意义(t=11.270、7.960、10.371，P<0.001);实验组并发症发生率2.27%低于参照组13.64%，组间差异有统计学意义(χ2=3.880，P=0.049)。 结论 在老年股骨粗隆间骨折临床治疗期间，采取防旋股骨近端髓内钉内固定微创治疗干预方式，能够提高临床治疗效果，改善患者各项指标情况，使患者尽早康复，具有较高的临床应用价值。
[关键词] 防旋股骨近端髓内钉;微创;股骨粗隆间骨折;老年
[中图分类号] R687.3+2 [文献标识码] A [文章编号] 1674-0742(2020)08(c)-0058-03
[Abstract] Objective To evaluate and analyze the clinical value of minimally invasive treatment of intertrochanteric fractures of the elderly with anti-rotation proximal intramedullary nails. Methods A total of 88 elderly patients with intertrochanteric fractures in the hospital were randomly selected from March 2016 to January 2019， and they were divided equally into the experimental group and the reference group. Among them， 44 patients in the experimental group received anti-rotation proximal femur Intramedullary nail (PFNA) internal fixation was minimally invasive treatment. 44 patients in the control group received dynamic hip screw (DHS) fixation. The operation time， blood loss， and incidence of adverse reactions were compared between the two groups. Results The operation time of the experimental group was (52.2±6.1) min， the healing time (12.4±1.6)weeks， and the blood loss (173.4±66.1) mL were significantly better than those of the reference group (69.7±8.3)min， (20.2±6.3)weeks，(297.9±44.4)mL， the differences was statistically significant between groups (t=11.270， 7.960， 10.371， P<0.001); the complication rate of the experimental group was 2.27%， lower than the reference group 13.64%， and the difference was statistically significant between the groups(χ2=3.880， P=0.049). Conclusion During the clinical treatment of elderly intertrochanteric fractures， the use of anti-rotation proximal femoral nail internal fixation minimally invasive treatment intervention can improve the clinical treatment effect， improve the patient’s various indicators， and enable the patient to recover as soon as possible. The value of clinical application.
[Key words] Anti-rotation proximal femoral nail; Minimally invasive; Femoral intertrochanteric fracture; Elderly
現如今，我国进入老龄化社会阶段，髋部骨折发生率逐年增长，根据相关研究表明[1]，髋部骨折发生几率占全身骨折1.4%左右，且多发于老年患者。髋部骨折在临床上以股骨粗隆间骨折较为常见，此疾病和骨质疏松存在一定的内在联系，会降低老年患者的生活品质。在临床治疗老年股骨粗隆间骨折疾病时，由于保守治疗具有较高的病死率，治疗效果不佳，容易对患者生命健康造成威胁。现阶段，对于此疾病主要以髓外固定与髓内固定方式为主，而髓内固定治疗方式较为常见。因防旋股骨近端髓内钉有着良好的固定效果，抗旋转作用效果良好，稳定性佳，能够预防并发症的发生，使患者尽早下床活动，有利于患者骨折处愈合，为此得到广泛的应用与关注[2-3]。为了进一步探究老年股骨粗隆间骨折采取防旋骨近端髓内钉固定微创治疗的临床价值，该文选取2016年3月—2019年1月该院收治老年股骨粗隆间骨折患者共计88例为研究对象展开研究，现报道如下。, 百拇医药(王闯)
[关键词] 防旋股骨近端髓内钉;微创;股骨粗隆间骨折;老年
[中图分类号] R687.3+2 [文献标识码] A [文章编号] 1674-0742(2020)08(c)-0058-03
[Abstract] Objective To evaluate and analyze the clinical value of minimally invasive treatment of intertrochanteric fractures of the elderly with anti-rotation proximal intramedullary nails. Methods A total of 88 elderly patients with intertrochanteric fractures in the hospital were randomly selected from March 2016 to January 2019， and they were divided equally into the experimental group and the reference group. Among them， 44 patients in the experimental group received anti-rotation proximal femur Intramedullary nail (PFNA) internal fixation was minimally invasive treatment. 44 patients in the control group received dynamic hip screw (DHS) fixation. The operation time， blood loss， and incidence of adverse reactions were compared between the two groups. Results The operation time of the experimental group was (52.2±6.1) min， the healing time (12.4±1.6)weeks， and the blood loss (173.4±66.1) mL were significantly better than those of the reference group (69.7±8.3)min， (20.2±6.3)weeks，(297.9±44.4)mL， the differences was statistically significant between groups (t=11.270， 7.960， 10.371， P<0.001); the complication rate of the experimental group was 2.27%， lower than the reference group 13.64%， and the difference was statistically significant between the groups(χ2=3.880， P=0.049). Conclusion During the clinical treatment of elderly intertrochanteric fractures， the use of anti-rotation proximal femoral nail internal fixation minimally invasive treatment intervention can improve the clinical treatment effect， improve the patient’s various indicators， and enable the patient to recover as soon as possible. The value of clinical application.
[Key words] Anti-rotation proximal femoral nail; Minimally invasive; Femoral intertrochanteric fracture; Elderly
現如今，我国进入老龄化社会阶段，髋部骨折发生率逐年增长，根据相关研究表明[1]，髋部骨折发生几率占全身骨折1.4%左右，且多发于老年患者。髋部骨折在临床上以股骨粗隆间骨折较为常见，此疾病和骨质疏松存在一定的内在联系，会降低老年患者的生活品质。在临床治疗老年股骨粗隆间骨折疾病时，由于保守治疗具有较高的病死率，治疗效果不佳，容易对患者生命健康造成威胁。现阶段，对于此疾病主要以髓外固定与髓内固定方式为主，而髓内固定治疗方式较为常见。因防旋股骨近端髓内钉有着良好的固定效果，抗旋转作用效果良好，稳定性佳，能够预防并发症的发生，使患者尽早下床活动，有利于患者骨折处愈合，为此得到广泛的应用与关注[2-3]。为了进一步探究老年股骨粗隆间骨折采取防旋骨近端髓内钉固定微创治疗的临床价值，该文选取2016年3月—2019年1月该院收治老年股骨粗隆间骨折患者共计88例为研究对象展开研究，现报道如下。, 百拇医药(王闯)