摘要
【摘要】 目的 探讨人工髋关节置换术和股骨近端防旋髓内钉（ PFNA）内固定术治疗老年股骨粗隆间骨折的疗效研究。方法 86例老年（≥ 70岁）股骨粗隆间骨折患者， 随机分为观察组和对照组， 每组 43例。观察组行人工髋关节置换术治疗， 对照组使用 PFNA内固定术治疗。比较两组患者各项手术指标（手术时间、术中出血量、术后下床活动时间、术后负重时间）， 术后 1周、 3个月、 6个月 Harris髋关节功能评分， 术后并发症（肺部感染、泌尿系统感染、深静脉血栓、压疮、心力衰竭）发生情况。结果 观察组患者手术时间（ 91.02±8.46） min与对照组的（ 88.29±12.14） min比较， 差异无统计学意义（ P>0.05）。观察组患者术后下床活动时间（ 8.72±1.31） d、术后负重时间（ 23.15±4.48） d均短于对照组的（ 40.25±3.86）、（ 76.32±7.23） d， 术中出血量（ 327.64±23.79） ml多于对照组的（ 213.52±20.07） ml， 差异均具有统计学意义（ P<0.05）。观察组患者术后 1周的 Harris髋关节功能评分（ 75.46±10.29）分与对照组的（ 74.95±10.78）分比较， 差异无统计学意义（ P>0.05）。观察组患者术后 3、 6个月的 Harris髋关节功能评分分别为（ 83.34±6.83）、（ 89.35±5.02）分， 均高于对照组的（ 76.11±8.24）、（ 82.51±5.67）分， 差异均具有统计学意义（ P<0.05）。观察组术后并发症发生率 9.30%低于对照组的 25.58%， 差异具有统计学意义（ P<0.05）。结论 人工髋关节置术治疗老年股骨粗隆间骨折的疗效更好， 术后恢复时间短， 髋关节功能恢复更好， 且术后并发症发生率低， 具有较好的疗效性及安全性。
【关键词】 股骨粗隆间骨折 ;人工髋关节置换术 ;股骨近端防旋髓内钉内固定术 ;疗效 ;老年
[Abstract] Objective To investigate the effect of total hip arthroplasty and proximal femoral nail antirotation (PFNA) in the treatment of intertrochanteric fractures in the elderly. Methods 86 elderly patients (≥ 70 years old) with intertrochanteric fracture were randomly divided into observation group and control group, 43 cases in each group. The observation group was treated with artificial hip replacement, while the control group was treated with PFNA internal fixation. The operation indexes (operation time, intraoperative blood loss, postoperative ambulation time, postoperative weight-bearing time), Harris hip function score and postoperative complications (pulmonary infection, urinary system infection, deep venous thrombosis, pressure ulcer, heart failure) were compared between the two groups. Results the operation time of the observation group was (91.02 ± 8.46) min and that of the control group was (88.29 ± 12.14) min, the difference was not statistically significant (P > 0.05). The postoperative ambulation time (8.72 ± 1.31) D and postoperative weight-bearing time (23.15 ± 4.48) d in the observation group were shorter than those in the control group (40.25 ± 3.86) and (76.32 ± 7.23) d, and the intraoperative blood loss (327.64 ± 23.79) ml was more than that of the control group (213.52 ± 20.07) ml, with statistical significance (P < 0.05). There was no significant difference in Harris hip function score between the observation group (75.46 ± 10.29) and the control group (74.95 ± 10.78) one week after operation (P > 0.05). The Harris hip function scores of the observation group at 3 and 6 months after operation were (83.34 ± 6.83) and (89.35 ± 5.02) respectively, which were higher than those of the control group (76.11 ± 8.24) and (82.51 ± 5.67) respectively, and the differences were statistically significant (P < 0.05). The incidence of postoperative complications in the observation group (9.30%) was lower than that in the control group (25.58%) (P < 0.05). Conclusion artificial hip arthroplasty in the treatment of elderly femoral intertrochanteric fracture has better curative effect, shorter postoperative recovery time, better hip joint function recovery, lower incidence of postoperative complications, and better efficacy and safety.
出版日期
2020年09月21日（中国期刊网平台首次上网日期，不代表论文的发表时间）
