摘要
目的比较股骨近端防旋髓内钉(PFNA)与人工股骨头置换术(BFHR)对于老年人股骨粗隆间骨折的临床疗效。方法选取我科自2015年5月至2017年5月53例老年股骨粗隆间骨折患者,根据手术方案不同,分为PFNA组(n=26)与BFHR组(n=27),对比2组患者的病例基线资料、围术期资料、术后并发症情况及术后短期髋关节功能Harris评分。结果 2组患者病例基线资料差异无统计学意义。PFNA组患者的切口长度、总显性失血量低于BFHR组,差异有统计学意义(P<0.05)。BFHR组患者的卧床时间、卧床相关并发症发生率低于PFNA组,术后2周和1个月髋关节Harris评分高于PFNA组,2组比较差异有统计学意义(P<0.05)。2组患者的手术时间差异无统计学意义(P>0.05)。结论对于手术耐受力较好,术中风险较小的患者采取BFHR术式,以缩短卧床时间,降低卧床相关并发症;对于手术耐受力较差,术中风险较高的患者,可选择PFNA术式。
Objective To compare the short-term efficacy of proximal femoral nail antirotation （PFNA） and bipolar femoral head replacement （BFHR） in the treatment of senile femoral interochanteric fractures. Methods A total of 53 patients with femoral intertrochanteric fracture in our department from May 2015 to May 2017 were divided into PFNA group （ n =26） and BFHR group（ n =27） according to surgery methods.The baselines,perioperative data,complications and Harris scores of the two groups were compared. Results No significant differences were found on the baselines of the two groups （ P 〉0.05）. The length of incision and total blood loss of PFNA group were lower than those of BFHR group,and the differences were significant（ P 〈0.05）.The in-bed time and in-bed related complications of BFHR group were lower than those of PFNA group,Harris score was higher than that of PFNA group at postoperative two weeks and one month,and the differences were significant （ P〈0.05）.No significant difference was found in operative time of the two groups （ P〉0.05）.Conclusion For the patients with lower surgical risk,BFHR should be the first choice,which can shorten the post-operative in-bed time and reduce the in-bed related complications;for the patients with higher surgical risk,PFNA can be chosen.
作者
张子琦
杨佩
王春生
王坤正
ZHANG Zi-qi;YANG Pei;WANG Chun-sheng;WANG Kun-zheng(Department of Orthopedics,the Second Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an Shaanxi 710004,China)
出处
《局解手术学杂志》
2018年第8期569-573,共5页
Journal of Regional Anatomy and Operative Surgery
