文章摘要
周 嵬,仲文军,林 程,阮子平,李 斌,徐 伟.动力髋螺钉与股骨近端髓内钉内固定治疗股骨粗隆间骨折患者的疗效及安全性和关节功能对比观察[J].,2019,19(8):1546-1549
动力髋螺钉与股骨近端髓内钉内固定治疗股骨粗隆间骨折患者的疗效及安全性和关节功能对比观察
Intertrochanteric Fracture of Femur: Comparison of Efficacy, Safety and Joint Function between Dynamic Hip Screw and Proximal Femoral Nail
投稿时间:2018-10-02  修订日期:2018-10-24
DOI:10.13241/j.cnki.pmb.2019.08.033
中文关键词: 动力髋螺钉  股骨近端髓内钉  内固定  股骨粗隆间骨折  疗效  安全性  关节功能
英文关键词: Dynamic hip screw  Proximal femoral nail  Internal fixation  Intertrochanteric fracture of femur  Efficacy  Safety
基金项目:安徽省卫生和计划生育委员会科研计划项目(2015KQ0337)
作者单位E-mail
周 嵬 安徽医科大学附属滁州临床学院/滁州市第一人民医院骨科 安徽 滁州 239000 zhoudoctor123@yeah.net 
仲文军 安徽医科大学附属滁州临床学院/滁州市第一人民医院骨科 安徽 滁州 239000  
林 程 安徽医科大学附属滁州临床学院/滁州市第一人民医院骨科 安徽 滁州 239000  
阮子平 安徽医科大学附属滁州临床学院/滁州市第一人民医院骨科 安徽 滁州 239000  
李 斌 安徽医科大学附属滁州临床学院/滁州市第一人民医院骨科 安徽 滁州 239000  
徐 伟 蚌埠医学院第一附属医院骨科 安徽 蚌埠 233004  
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中文摘要:
      摘要 目的:比较动力髋螺钉(DHS)与股骨近端髓内钉(PFNA)内固定治疗股骨粗隆间骨折患者的疗效及安全性和关节功能。方法:选取滁州市第一人民医院于2013年3月~2018年4月期间收治的160例股骨粗隆间骨折患者,根据内固定方式的不同将患者分为DHS组(n=80,采用DHS内固定)和PFNA组(n=80,采用PFNA内固定),比较两组临床疗效,采用髋关节功能Harris评分评价所有患者关节功能恢复情况,比较两组患者术前及术后相关指标,并观察患者术后并发症发生情况。结果:PFNA组患者临床总有效率为90.00%,高于DHS组患者的68.75%(P<0.05)。两组患者Harris评分的优良率比较差异无统计学意义(P>0.05)。PFNA组患者手术时间、卧床时间、骨折愈合时间、切口长度均短于DHS组(P<0.05),术中出血量、术后引流量均少于DHS组(P<0.05)。两组患者术后并发症总发生率比较无统计学差异(P>0.05)。结论:DHS与PFNA内固定治疗股骨粗隆间骨折在术后关节功能恢复、安全性方面效果相当,但与DHS内固定治疗比较,PFNA内固定治疗的临床疗效更佳,手术时间更短,出血量更少,患者术后恢复更快,是治疗股骨粗隆间骨折较理想的手术方式。
英文摘要:
      ABSTRACT Objective: To compare the efficacy, safety and joint function of dynamic hip screw (DHS) and proximal femoral nail (PFNA) in the treatment of intertrochanteric fracture of femur. Methods: A total of 160 patients with intertrochanteric fracture, who were treated in the First People's Hospital of Chuzhou from March 2013 to April 2018, were selected and were divided into DHS group (n=80,DHS treatment) and PFNA group (n=80, PFNA treatment) according to different internal fixation methods. The clinical efficacy of the two groups was compared. Hip function Harris score was used to evaluate the recovery of joint function in all patients. The preoperative and postoperative indicators were compared between the two groups, and the postoperative complications were observed. Results: The total effective rate in PFNA group was 90.00%, which was higher than that(68.75%) in DHS group (P<0.05). There was no significant difference in the Harris score between the two groups (P>0.05). The operation time, bed rest time,fracture healing time and incision length of PFNA group were shorter than those of DHS group (P<0.05). The intraoperative bleeding volum and postoperative drainage volum in PFNA group were less than those in DHS group (P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: In the treatment of patients with femoral intertrochanteric fracture, DHS and PFNA internal fixation have the same effect on joint function recovery and safety after operation, but compared with DHS internal fixation, PFNA internal fixation has better clinical effect, shorter operation time, less bleeding, and faster postoperative recovery, which is an ideal surgical method in the treatment of intertrochanteric fracture of femur.
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