DHS螺旋刀片治疗Evans―JensenⅠ、Ⅱ型股骨粗隆间骨折临床效果.doc

DHS螺旋刀片治疗Evans―JensenⅠ、Ⅱ型股骨粗隆间骨折临床效果 　　[摘要]目的 探讨动力髋螺钉（DHS）螺旋刀片治疗稳定型股骨粗隆间骨折的临床意义。方法 选取2011年1月～2015年9月我院收治的48例老年Evans-JensenⅠ、Ⅱ型股骨粗隆间骨折手术患者作为研究对象。根据不同的治疗方法分为DHS螺旋刀片组（n=28）和防旋股骨近端髓内钉（PFNA）组（n=20），DHS螺旋刀片组采用DHS螺旋刀片治疗，而PFNA组采用PFNA进行治疗，比较两组患者的治疗效果。结果 术后随访12个月，两组患者手术时间、住院时间、骨折愈合时间、术中出血量比较，差异无统计学意义（P0.05）；DHS螺旋刀片组围术期失血总量、术中透视时间明显少于PFNA组，差异有统计学意义（P0.05）。结论 DHS螺旋刀片和PFNA对稳定型粗隆?g骨隆间骨折均有良好的治疗效果，DHS螺旋刀片具有减少围术期失血总量、术中透视时间的优势 [关键词]DHS螺旋刀片；防旋股骨近端髓内钉；股骨粗隆间骨折 [中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721（2016）11（c）-0077-03 [Abstract]Objective To study the clinical significance of dynamic hip screw （DHS） spiral blade in the treatment of stable femoral intertrochanteric fracture.Methods 48 elderly patients with Evans-JensenⅠ，Ⅱfemoral intertrochanteric fracture in our hospital from January 2011 to September 2015 were selected as study object and divided into DHS spiral blade group （n=28）and proximal femoral nail antirotation （PFNA） group （n=20） according to different treatment methods，DHS spiral blade group were treated by DHS spiral blade，while PFNA group was treated by PFNA.Treatment effects between two groups were compared.Results After 12 months followed-up，there was no statistical difference in operation time，length of hospital stay，healing time of fracture，blood loss volume during operation between two groups （P0.05）；perioperative total blood loss，intraoperative fluoroscopy time in the DHS spiral blade group was obviously less than that in the PFNA group，and the difference was statistically significant （P0.05）.Conclusion The therapeutic effect of PFNA and DHS spiral blade are good in the treatment of stable femoral intertrochanteric fracture.DHS spiral blade has advantages to reduce perioperative total blood loss and intraoperative fluoroscopy time. [Key words]Dynamic hip screw spiral blade；Proximal femoral nail antirotation；Femoral intertrochanteric fractures 股骨粗隆间骨折多见骨质疏松脆性骨折老年人，轻微暴力如摔倒即可引起。随着社会人口老龄化的发展，股骨粗隆间骨折发生率升高，Ruecker等[1]预计25年内将升高1倍。股骨粗隆间骨折保守治疗需长期卧床制动，易致髋部疼痛及膝部僵直