股骨近端防旋髓内钉与人工股骨头置换术治疗高龄股骨转子间骨折临床效果分析.doc

股骨近端防旋髓内钉与人工股骨头置换术治疗高龄股骨转子间骨折临床效果分析 ［摘要］目的比较股骨近端抗旋髓内钉植入 （PFNA）与人工股骨头置换术（AFHR）治疗高龄股骨 转子间骨折的临床效果。方法回顾性分析2024年1 月?2016年1月连云港市赣榆区人民医院收治的61 例股骨转子间骨折患者，其中34例采用抗旋髓内钉植 入治疗（PFNA组），27例采用人工股骨头置换术（AFHR 组）。分别比较两组患者手术时间、术中岀血量、围术 期出血量、术后住院天数、首次下地负重时间、骨折 愈合时间，并在随访时应用Harris评分评价患者體关 节功能。结果PFNA组的手术时间、术中出血量、骨 折愈合时间均少于AFHR组，而围术期出血量及首次 下地负重时间大于AFHR组，差异均有统计学意义（均 P 0.05）o结论PFNA与AFHR在临床上治疗高龄股 骨转子间骨折均有较好的效果，但前者具有手术时间 短、术中出血量少、骨折愈合时间短的优点。 ［关键词］股骨近端抗旋髓内钉植入；人工股骨头 置换术；股骨转子间骨折；高龄患者；Harris评分 ［中图分类号］R683.420.5 ［文献标识码］A ［文章编 号]1673-7210 (2016) 10 (c) -0083-04 [Abstract] Objective To compare the clinical efficacy between the proximal femoral nail anti-rotation (PFNA) and artificial femoral head replacement (AFHR) in the treatment of elderly patients with intertrochanteric fractures? Methods 61 cases of patients with intertrochanteric fracture treated in Peoples Hospital of Ganyu District in Lianyungang City from January 2014 to January 2016 were analzyed retrospective!y. 34 cases were treated with PFNA (PFNA group), 27 cases were treated with AFHR (AFHR group)? The operative 廿me, intraoperative blood loss, perioperative blood loss, postoperative hospital stay, the first weight-bearing ambulation time, fracture healing time were compared between the two groups? Harris score was used to evaluate the hip joint function during the follow-up time. Results The operative time, intraoperative blood loss, fracture healing time of the PFNA group were less than those of the AFHR group, while the perioperative blood loss and the first weight-bearing ambulation time were more/later than those of the AFHR group, with statistically sign ifica nt d iff ere nces (P 0.05)? Conclusion PFNA and AFHR in the treatment of elderly patients with intertrochanteric fractures all have good effects, but PFNA has the advantages of shorter time of operation， less intraoperative blood loss, shorter time of fracture healing. ［Key words］ Proximal femoral nail anti-rotation； Artificial femoral head replacement； Intertrochanteric frac