DHS、LPFP、PFNA治疗老年股骨粗隆间骨折的随机对照研究

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摘要 [摘要]目的比较动力髋螺钉（DHS）、股骨近端锁定钢板（LPFP）、股骨近端防旋髓内钉（PFNA）治疗老年股骨粗隆间骨折的效果。方法选取我院2017年1月～2018年9月收治的120例股骨粗隆间骨折老年患者为研究对象，按照随机排测法，将患者分为DHS组、LPFP组、PFNA组，各40例。比较三组的手术时间、术中出血量、住院时间和负重时间，并发症发生情况，术前、术后2周、1个月的Harris髋关节功能评分。结果 PFNA组的手术时间、住院时间、负重时间均短于DHS、LPFP组，术中出血量少于DHS、LPFP组，差异有统计学意义（P<0.001）。三组的并发症总发生率比较，差异无统计学意义（P＞0.05）。三组术后2周、1个月的Harris髋关节功能评分均高于术前，差异有统计学意义（P<0.05），PFNA组术后2周、1个月的Harris髋关节功能评分明显高于DHS、LPFP组，差异有统计学意义（P＜0.001）。结论对于股骨粗隆间骨折患者，PFNA治疗方法能有效减少术中出血，缩短手术时间，患者可以提早下地活动，髋关节恢复效果好，康复时间短，术后不易发生并发症，具有较好的治疗效果。

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关键词 ：股骨近端防旋髓内钉, 老年股骨粗隆间骨折, 随机对照分析, 动力髋螺钉, 股骨近端锁定钢板

Abstract：[Abstract]Objective To compare the clinical effect of dynamic hip screw (DHS),proximal femoral locking plate(LPFP),Proximal femoral anti-rotation intramedullary nail(PFNA)in the treatment of intertrochanteric fracture of the femur in the elderly.Methods All of 120 elderly patients with intertrochanteric fracture of femur admitted to our hospital from January 2017 to September 2018 were selected as the research objects.According to random ranking method,they were divided into the DHS group,LPFP group and PFNA group,40 cases in each group.The operation time,intraoperative bleeding volume,hospital stay and weight-bearing time,the incidence of complications,Harris hip function score before operation and at 2 weeks and 1 month after operation were compared among the three groups.Results The operation time,hospitalization time and weight-bearing time of the PFNA group were shorter than those of the DHS and LPFP group,and the intraoperative bleeding volume was less than that of the DHS and LPFP group,and the differences were statistically significant(P<0.001).There was no significant difference in the total incidence of complications among the three groups(P>0.05).The Harris hip function score of the three groups at 2 weeks and 1 month after operation was higher than those before operation,and the differences were statistically significant(P<0.05).The Harris hip function scores of the PFNA group at 2 weeks and 1 month after operation were significantly higher than those of the DHS and LPFP group,and the differences were statistically significant(P<0.001).Conclusion For patients with intertrochanteric fracture of femur,PFNA treatment can effectively reduce intraoperative bleeding volume and shorten the operation time,and the patients can move to the ground earlier,and the recovery effect of hip joint is good,the recovery time is short,and complications are not easy to occur after operation.It has better therapeutic effect.

Key words： Proximal femoral anti-rotation intramedullary nail Intertrochanteric fracture of femur in the elderly Randomized controlled analysis Dynamic hip screw Proximal femoral locking plate

基金资助:广东省清远市科技计划项目（170815201900575）

作者简介: 梁斐（1982-），男，海南屯昌人，本科，主治医师，研究方向：创伤骨科

引用本文:

梁斐；谭哲君；何丽丽；房辉强；万富贵. DHS、LPFP、PFNA治疗老年股骨粗隆间骨折的随机对照研究[J]. 中国当代医药, 2019, 26(7): 117-119转127.
LIANG FeiTAN Zhe-jun HE Li-liFANG Hui-qiang WAN Fu-gui. A randomized controlled study of DHS,LPFP and PFNA in the treatment of intertrochanteric fracture of the femur in the elderly. 中国当代医药, 2019, 26(7): 117-119转127.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2019/V26/I7/117

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