摘要
【目的】探讨股骨近端防旋髓内钉(PFNA-Ⅱ)治疗股骨转子间骨折对患者髋关节功能及血清炎症相关因子的影响。【方法】选择2019年1月至2022年1月本院收治的160例股骨转子间骨折患者,按照随机数字表法分为观察组和对照组,每组80例,观察组采用PFNA-Ⅱ髓内钉治疗,对照组采用动力髋螺钉(DHS)治疗。比较两组患者手术情况[手术时间、切口长度、出血量、住院时间与骨折愈合时间]、术后并发症发生率、手术前后炎症因子水平及术后1个月、3个月、6个月、12个月髋关节Harris评分。【结果】观察组患者手术时间、切口长度以及出血量均少于对照组(P<0.05);但两组患者住院时间、骨折愈合时间比较,差异无统计学意义(P>0.05)。术后1个月、3个月、6个月,观察组髋关节Harris评分均高于对照组(P<0.05);术后12个月,两组髋关节Harris评分比较,差异无统计学意义(P>0.05)。两组术后白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)水平均低于术前,且观察组低于对照组(P<0.05)。观察组并发症发生率显著低于对照组(P<0.05)。【结论】PFNA-Ⅱ髓内钉治疗股骨转子间骨折可有效改善患者髋关节功能,降低血清炎症因子水平,缓解患者术后疼痛,且患者术后并发症发生率低,值得临床推广应用。
【Objective】To investigate the effects of proximal femoral anti rotation intramedullary nail(PFNA-Ⅱ)on hip joint function and serum inflammatory factors in patients with intertrochanteric fractures.【Methods】A total of 160 patients with intertrochanteric fractures of the femur admitted to our hospital from January 2019 to January 2022 were randomly divided into an observation group and a control group using a random number table method,with 80 patients in each group.The observation group was treated with PFNA-Ⅱintramedullary nails,while the control group was treated with dynamic hip screws(DHS).We compared the surgical conditions of two groups of patients[surgical time,incision length,bleeding volume,hospital stay,and fracture healing time],the incidence of postoperative complications,the levels of inflammatory factors before and after surgery,and the Harris score of the hip joint at 1,3,6,and 12 months after surgery.【Results】The surgical time,incision length,and bleeding volume in the observation group were all lower than those in the control group(P<0.05);However,there was no statistically significant difference in hospital stay and fracture healing time between the two groups of patients(P>0.05).At 1 month,3 months,and 6 months after surgery,the Harris score of the hip joint in the observation group was higher than that in the control group(P<0.05);At 12 months after surgery,there was no statistically significant difference in Harris scores between the two groups of hip joints(P>0.05).The levels of postoperative interleukin-1β(IL-1β),Interleukin 6(IL-6),interleukin-18(IL-18)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).【Conclusion】PFNA-Ⅱintramedullary nail treatment for intertrochanteric fractures of the femur can effectively improve hip joint function,reduce serum inflammatory factor levels,alleviate postoperative pain,and have a low incidence of postoperative complications,which is worthy of clinical promotion and application.
作者
张磊
杨萌国
ZHANG Lei;YANG Meng-guo(Department of Trauma and Orthopedics,Shaanxi Nuclear Industry 215th Hospital,Xianyang Shaanxi 712000)
出处
《医学临床研究》
CAS
2023年第6期862-865,共4页
Journal of Clinical Research
