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三种内固定手术对高龄股骨转子间骨折术后隐性失血量及预后情况的影响 被引量:2

Effect of Three Kinds of Internal Fixation on Occult Blood Loss and Prognosis after Intertrochanteric Fracture Surgery in Elderly Patients
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摘要 目的:探究三种内固定手术对高龄股骨转子间骨折术后隐性失血量及预后情况的影响。方法:选取2017年9月-2018年10月我院收治的高龄股骨转子间骨折患者115例,按固定方法不同分为股骨近端抗旋髓内钉(PFNA)组43例、股骨近端锁定钢板(PFLP)组38例、动力髋螺钉(DHS)组34例。观察三组手术相关指标,同时比较3组不同时点的隐性失血量、日常生活活动能力表(ADL)评分。结果:PFNA组手术时间、切口长度、骨折愈合时间均明显优于其他两组,组间差异有统计学意义(P<0.05);术后1d、2~3d、4~5d,PFNA组隐性失血量均明显低于其他两组,组间差异有统计学意义(P<0.05);术后3、6个月,PFNA组ADL评分明显高于其他两组,组间差异有统计学意义(P<0.05)。结论:相较于DHS、PFLP,PFNA治疗高龄股骨转子间骨折患者手术效果较好,患者隐性失血量少,预后较好。 Objective:To explore the influence of three kinds of internal fixation on the occult blood loss and prognosis of elderly patients with intertrochanteric fracture after operation.Methods:115 elderly patients with intertrochanteric fracture were selected from September 2017 to October 2018.They were divided into proximal femoral anti-rotating intramedullary nail (PFNA) group of 43 cases,proximal femoral locking plate (PFLP) group of 38 cases and dynamic hip screw (DHS) group of 34 cases according to different fixation methods.The operation related indexes were observed in three groups, and the latent blood loss and ADL scores at different time points were compared among the three groups.Results:The operation time, incision length and fracture healing time of PFNA group were significantly better than those of the other two groups, with significant difference between the two groups( P <0.05);the hidden blood loss of PFNA group was significantly lower than that of the other two groups at 1,2 to 3 and 4 to 5 days after operation ( P <0.05);the ADL score of PFNA group was significantly higher than that of the other two groups at 3 and 6 months after operation ( P <0.05).Conclusion:Compared with DHS and PFLP,PFNA is more effective in the treatment of elderly patients with intertrochanteric fracture,with less latent blood loss and better prognosis.
作者 严明 YAN Ming(Xishui Hospital of Chinese Medicine,Xishui County,Hubei Province 438200)
出处 《医学理论与实践》 2019年第11期1634-1636,共3页 The Journal of Medical Theory and Practice
关键词 高龄股骨转子间骨折 骨折固定术 隐性失血量 预后 Intertrochanteric fracture of femur in the elderly Fracture fixation Occult blood loss Prognosis
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