PFNA治疗高龄患者股骨近端骨折疗效观察(1)
摘要：目的 探讨PFNA内固定治疗高龄患者股骨近端骨折的效果。方法 采用随机数字表法，将2014年6月～2016年12月在我院接受治疗的60例股骨近端骨折的高龄患者分成观察组与对照组，每组各30例，观察组接受防旋股骨近端髓内钉内固定术，对照组接受动力髋螺钉内固定术，记录两组患者的手术时间、出血量、切口长度、术中输液量、骨折愈合时间、并发症、Harris评分。结果 观察组的手术时间、出血量、切口长度、术中输液量、骨折愈合时间、并发症发生率均小于对照组，差异有统计学意义(P<0.05)，观察组的Harris评分高于对照组差异有统计学意义(P<0.05)。结论 PFNA内固定治疗高龄患者股骨近端骨折操作方便、创伤较小、并发症少、关节功能恢复满意。
关键词：PFNA；股骨近端骨折；高龄；内固定
中图分类号：R687.3 文献标识码：A 文章编号：1006-1959(2017)19-0058-03
, 百拇医药 Clinical Observation of PFNA in the Treatment of Proximal Femoral Fractures in Elderly Patients
ZOU Yi
(Department of Orthopedics，Guang'an Hospital/Guang'an People's Hospital，Sichuan University，Guang'an 638000，Sichuan，China)
Abstract：Objective To investigate the effect of PFNA internal fixation for the treatment of elderly patients with proximal femoral fractures.Methods According to the random number table method，60 cases of elderly patients with femur in June 2014～December 2016，in our hospital for treatment of proximal fracture were divided into observation group and control group，30 cases in each group，the observation group received anti rotation proximal femoral intramedullary screw internal fixation，the control group received dynamic hip screw fixation，record the operation time，two groups of patients with bleeding，incision length，intraoperative transfusion volume，fracture healing time，complications，Harris score.Results In the observation group，the operation time，bleeding volume，incision length，intraoperative transfusion volume，fracture healing time，complication rate was less than the control group， the difference was statistically significant(P<0.05)，the Harris score of observation group was higher than that of the control group had significant difference(P<0.05).Conclusion PFNA internal fixation for the treatment of elderly patients with proximal femoral fractures has the advantages of convenient operation，less trauma，less complications，and satisfactory functional recovery.
, 百拇医药
Key words：PFNA；Proximal femoral fracture；Advanced age；Internal fixation
隨着我国社会经济的发展与医疗卫生水平的提高，社会成员的平均寿命延长，我国已进入老龄化社会，临床工作中的高龄患者越来越多，由于合并骨质疏松等原因，股骨近端骨折在高龄患者较为常见[1]。由于保守治疗卧床时间长，易导致肺部感染及深静脉血栓等并发症[2]，临床上对此类患者常常给予手术治疗，防旋股骨近端髓内钉(proximal femoral nail antirotation blade，PFNA)是近年开展的治疗股骨近端骨折的新手术方法，我们用于治疗高龄患者取得了良好的效果，现报道如下。
1 资料与方法
1.1一般资料
经医院伦理委员会批准，患者及家属签署知情同意书，选择我院2014年6月～2016年12月拟行股骨近端骨折复位内固定患者60例，年龄80～99岁，平均年龄86.5岁，其中男24例，女36例，股骨粗隆下骨折20例，股骨颈基底部骨折11例、股骨粗隆间骨折29例，受伤后至手术时间2～13 d。60例患者中合并高血压19例，冠心病10例，糖尿病5例，肺部感染 8例。以随机数字表法分为两组，每组30例，两组间年龄、性别、受伤时间、合并症等比较差异无统计学意义(P>0.05)，观察组采用PFNA内固定治疗，对照组采用动力髋螺钉(dynamic hip screw，DHS)内固定治疗。, http://www.100md.com(邹懿)
关键词：PFNA；股骨近端骨折；高龄；内固定
中图分类号：R687.3 文献标识码：A 文章编号：1006-1959(2017)19-0058-03
, 百拇医药 Clinical Observation of PFNA in the Treatment of Proximal Femoral Fractures in Elderly Patients
ZOU Yi
(Department of Orthopedics，Guang'an Hospital/Guang'an People's Hospital，Sichuan University，Guang'an 638000，Sichuan，China)
Abstract：Objective To investigate the effect of PFNA internal fixation for the treatment of elderly patients with proximal femoral fractures.Methods According to the random number table method，60 cases of elderly patients with femur in June 2014～December 2016，in our hospital for treatment of proximal fracture were divided into observation group and control group，30 cases in each group，the observation group received anti rotation proximal femoral intramedullary screw internal fixation，the control group received dynamic hip screw fixation，record the operation time，two groups of patients with bleeding，incision length，intraoperative transfusion volume，fracture healing time，complications，Harris score.Results In the observation group，the operation time，bleeding volume，incision length，intraoperative transfusion volume，fracture healing time，complication rate was less than the control group， the difference was statistically significant(P<0.05)，the Harris score of observation group was higher than that of the control group had significant difference(P<0.05).Conclusion PFNA internal fixation for the treatment of elderly patients with proximal femoral fractures has the advantages of convenient operation，less trauma，less complications，and satisfactory functional recovery.
, 百拇医药
Key words：PFNA；Proximal femoral fracture；Advanced age；Internal fixation
隨着我国社会经济的发展与医疗卫生水平的提高，社会成员的平均寿命延长，我国已进入老龄化社会，临床工作中的高龄患者越来越多，由于合并骨质疏松等原因，股骨近端骨折在高龄患者较为常见[1]。由于保守治疗卧床时间长，易导致肺部感染及深静脉血栓等并发症[2]，临床上对此类患者常常给予手术治疗，防旋股骨近端髓内钉(proximal femoral nail antirotation blade，PFNA)是近年开展的治疗股骨近端骨折的新手术方法，我们用于治疗高龄患者取得了良好的效果，现报道如下。
1 资料与方法
1.1一般资料
经医院伦理委员会批准，患者及家属签署知情同意书，选择我院2014年6月～2016年12月拟行股骨近端骨折复位内固定患者60例，年龄80～99岁，平均年龄86.5岁，其中男24例，女36例，股骨粗隆下骨折20例，股骨颈基底部骨折11例、股骨粗隆间骨折29例，受伤后至手术时间2～13 d。60例患者中合并高血压19例，冠心病10例，糖尿病5例，肺部感染 8例。以随机数字表法分为两组，每组30例，两组间年龄、性别、受伤时间、合并症等比较差异无统计学意义(P>0.05)，观察组采用PFNA内固定治疗，对照组采用动力髋螺钉(dynamic hip screw，DHS)内固定治疗。, http://www.100md.com(邹懿)
参见：首页 > 医疗版 > 疾病专题 > 骨科 > 骨折