摘要
目的对比股骨近端防旋髓内钉(PFNA)与加压交锁髓内钉(InterTan)治疗2型糖尿病并不稳定股骨粗隆间骨折的效果。方法研究对象均为方便选取于2018年1月—2020年12月该院收治的59例2型糖尿病并不稳定股骨粗隆间骨折患者,以随机数表法划分为两组。对照组29例应用PFNA髓内钉内固定治疗,研究组30例应用InterTan髓内钉内固定治疗。比较两组患者的手术相关指标、术前与术后血糖指标、治疗优良率与术后并发症情况。结果研究组手术时间(68.52±4.85)min、术后引流量(80.30±5.58)mL与术中出血量(260.52±23.48)mL较对照组(62.05±5.47)min、(72.47±8.66)mL、(180.65±16.78)mL高,差异有统计学意义(t=4.811、4.143、14.987,P<0.05),首次离床时间(6.65±3.52)d较对照组(8.55±2.66)d低,差异有统计学意义(t=2.333,P<0.05),研究组住院时间(14.30±2.85)d与对照组(14.68±3.02)d对比,差异无统计学意义(t=0.497,P>0.05)。术后,研究组空腹血糖(8.23±3.05)mmol/L、餐后2 h血糖(12.85±2.65)mmol/L、糖化血红蛋白(9.85±3.02)%与对照组(8.32±3.00)mmol/L、(12.80±3.02)mmol/L、(9.88±3.05)%对比,差异无统计学意义(t=0.114、0.068、0.038,P>0.05)。研究组治疗的优良率93.33%较对照组68.97%高,差异有统计学意义(χ^(2)=5.773,P<0.05)。在术后并发症发生率对比中,研究组4.26%较对照组31.03%更低,差异有统计学意义(χ^(2)=5.773,P<0.05)。结论相较于PFNA,InterTan髓内钉治疗2型糖尿病并不稳定股骨粗隆间骨折的效果更为理想,能够有效改善髋关节功能,降低并发症风险,适于临床推广。
Objective To compare the effect of proximal femoral anti-rotation intramedullary nail(PFNA)and compression interlocking intramedullary nail(InterTan)in the treatment of type 2 diabetic and unstable femoral intertrochanteric fractures.Methods The study subjects were all 59 patients with type 2 diabetes and unstable femoral intertrochanteric fractures conveniently selected to the hospital from January 2018 to December 2020.They were divided into two groups by a random number table.29 cases in the control group were treated with PFNA intramedullary nail internal fixation,and 30 cases in the study group were treated with InterTan intramedullary nail internal fixation.The operation-related indexes,preoperative and postoperative blood glucose indexes,treatment excellent rate and postoperative complications of the two groups were compared.Results The operative time(68.52±4.85)min,postoperative drainage volume(80.30±5.58)mL and intraoperative blood loss(260.52±23.48)mL in the study group were higher than those in the control group(62.05±5.47)min,(72.47±8.66)mL,(180.65±16.78)mL,the difference was statistically significant(t=4.811,4.143,14.987,P<0.05).The time of first bed departure(6.65±3.52)d was lower than that of the control group(8.55±2.66)d,the difference was statistically significant(t=2.333,P<0.05).There was no statistically difference in hospital stay between the study group(14.30±2.85)d and the control group(14.68±3.02)d(t=0.497,P>0.05).Postoperatively,fasting blood glucose(8.23±3.05)mmol/L,2 h postpranpranal blood glucose(12.85±2.65)mmol/L,HbA1c(9.85±3.02)%in the study group had no statistically significant difference compared with the control group(8.32±3.00)mmol/L,(12.80±3.02)mmol/L,(9.88±3.05)%(t=0.114,0.068,0.038,P>0.05).The excellent and good rate of 93.33%in study group was higher than 68.97%in control group,the difference was statistically significant(χ^(2)=5.773,P<0.05).The incidence of postoperative complications in the study group(4.26%)was lower than in the control group(31.03%),the difference was statistically significant(χ^(2)=5.773,P<0.05).Conclusion Compared with PFNA,InterTan intramedullary nails are more effective in treating type 2 diabetic and unstable femoral intertrochanteric fractures.It can effectively improve hip joint function,reduce the risk of complications,and is suitable for clinical promotion.
作者
陈明升
CHEN Mingsheng(Department of Orthopedics,Second Hospital of Sanming City,Sanming,Fujian Province,366000 China)
出处
《中外医疗》
2022年第2期50-53,57,共5页
China & Foreign Medical Treatment
