【摘要】 目的评价PFNA内固定与人工关节置换在高龄患者不稳定型股骨粗隆间骨折的治疗中的疗效。方法选取2010年1月至2013年6月我院收治的86例高龄不稳定型股骨粗隆间骨折患者为研究对象,根据治疗方式的不同将其分为A组和B组各43例,A组患者行人工关节置换术,B组患者行PFNA内固定术。观察比较两组患者的手术时间、术中出血量、术后引流量、卧床时间、术后并发症发生情况以及临床疗效。结果 A组手术时间与卧床时间明显短于B组,术中出血量与术后引流量明显高于B组,差异具有显著的统计学意义(P<0.01);A组并发症发生率为2.3%,显著低于B组的18.6%,差异具有统计学意义(P<0.05);A组优良率为79.1%,与B组(67.4%)相比无显著差异(P>0.05)。结论 PFNA内固定与人工关节置换在治疗高龄患者不稳定型股骨粗隆间骨折中各有优缺点,应根据实际情况综合考量,选择适宜的手术方式。更多还原

【Abstract】 Objective To evaluate the curative effect of internal fixation with proximal femoral nail antirotation(PFNA) and artificial joint replacement in elderly patients with unstable intertrochanteric fractures. Methods 86 elderly patients with unstable intertrochanteric fractures treated in our hospital from January 2010 to June 2013 were selected and divided into group A and group B according to different treatment methods, with 43 cases in each group. The group A was treated with artificial joint replacement, group B was given internal fixation with PFNA for treating. The operation time, bleeding volume during operation, postoperative drainage, bed rest time, complication and clinical effect between two groups were observed and compared. Results The operation time and bed rest time of group A were significantly shorter than those of group B, the bleeding volume during operation and postoperative drainage of group A were significantly higher than those of group B, all the difference was statistical(P <0.01); the incidence of complications in group A was 2.3%, significantly lower than 18.6% in group B, with statistical difference(P <0.05); the excellent and good rate of two groups had no statistical difference(79.1% vs 67.4%, P >0.05). Conclusions Both internal fixation with PFNA and artificial joint replacement have their advantages and disadvantages in treating elderly patients with unstable intertrochanteric fractures, we should select the appropriate treatment method according to patients’ practical situations.更多还原