摘要
目的探讨闭合复位股骨近端抗旋髓内钉(PFNA)治疗不稳定性股骨转子间骨折的效果。方法回顾性分析2014年10月至2018年10月在冀中能源峰峰集团总医院行手术治疗的不稳定性股骨转子间骨折(AO/OTA 31-A2,A3型)病人120例,依据手术方式的不同分为对照组与观察组,对照组59例行动力髋螺钉(DHS)治疗,观察组61例行PFNA治疗。对比两组手术指标、Harris评分与生活自理能力,测定血红蛋白与血细胞比容水平,统计并发症发生率。结果观察组切口长度短于对照组[(6.68±2.19)cm比(11.43±2.65)cm,P<0.05],总失血量[(565.93±173.68)mL比(946.37±325.31)mL]、术后引流量[(72.48±10.61)mL比(82.65±11.42)mL]均少于对照组(P<0.05),手术时间[(63.56±8.77)min比(82.08±9.13)min]、住院时间[(15.68±4.14)d比(22.76±5.43)d]、部分负重时间[(10.18±2.06)d比(16.91±5.29)d]均少于对照组(P<0.05),两组骨折愈合时间比较,差异无统计学意义[(10.89±2.64)d比(11.35±2.46)d,P>0.05];随访1年两组Harris评分与生活自理能力评分均高于术前(P<0.05),且随访1年观察组Harris评分[(83.63±11.32)分比(80.05±7.64)分]与生活自理能力评分[(90.09±3.13)分比(79.85±4.26)分]高于对照组(P<0.05);术后7 d两组血红蛋白与血细胞比容水平均低于术前(P<0.05),且术后7 d观察组血红蛋白与血细胞比容水平均高于对照组(P<0.05);观察组并发症总发生率低于对照组(6.56%比23.73%,P<0.05)。结论闭合复位PFNA治疗不稳定性股骨转子间骨折,能优化多项手术指标,提高髋关节功能与生活自理能力,减少失血量,且有助于预防并发症发生。
Objective To investigate the effect of closed reduction and proximal femoral nail anti rotation(PFNA)in the treatment of un‐stable intertrochanteric fracture.Methods One hundred and twenty patients with unstable intertrochanteric fracture(AO/OTA 31-A2,A3 type)who were operated in Jizhong Energy Fengfeng Group General Hospital from October 2014 to October 2018 were analyzed retrospec‐tively.According to the different operation methods,they were assigned into control group and study group,59 patients in control group were treated with dynamic hip screw(DHS)and 61 patients in study group were treated with PFNA.The operation index,Harris score and self-care ability were compared between the two groups,the levels of hemoglobin and hematocrit were measured,and the incidence of com‐plications was counted.Results The incision length of the study group was shorter than that of the control group[(6.68±2.19)cm vs.(11.43±2.65)cm,P<0.05];the total blood loss[(565.93±173.68)mL vs.(946.37±325.31)mL]and postoperative drainage[(72.48±10.61)mL vs.(82.65±11.42)mL]were less than those in the control group(P<0.05);the operation time[(63.56±8.77)min vs.(82.08±9.13)min],hospitalization time[(15.68±4.14)d vs.(22.76±5.43)d]and partial load-bearing time[(10.18±2.06)d vs.(16.91±5.29)d]were all less than those in the control group(P<0.05),while there was no significant difference in fracture healing time between the two groups[(10.89±2.64)d vs.(11.35±2.46)d,P>0.05];after 1 year follow-up,Harris score[(83.63±11.32)vs.(80.05±7.64)]and self-care ability score[(90.09±3.13)vs.(79.85±4.26)]of the two groups were higher than those before operation(P<0.05),and the Harris score and self-care ability score of the study group were higher than those of the control group(P<0.05);the levels of hemoglobin and hematocrit in the two groups were lower than those before operation(P<0.05),and the levels of hemoglobin and hematocrit in the study group were higher than those in the control group(P<0.05);and the total incidence of complications in the study group was lower than that in the control group(6.56%vs.23.73%,P<0.05).Conclusion Closed reduction and PFNA in the treatment of unstable intertrochanteric fracture can optimize a number of surgical indica‐tors,improve the function of hip joint and self-care ability of life,reduce blood loss,and help to prevent complications.
作者
吕品
褚会军
LYU Pin;CHU Huijun(No.2 Department of Bone,Jizhong Energy Fengfeng Group General Hospital,Handan,Hebei 056299,China)
出处
《安徽医药》
CAS
2021年第11期2228-2232,共5页
Anhui Medical and Pharmaceutical Journal
