【摘要】 目的:探讨应用股骨近端防旋髓内钉(PFNA)联合抗骨质疏松药物治疗老年股骨粗隆间骨折患者的临床效果。方法:选取2010年1月-2015年12月本院收治的老年骨质疏松性股骨粗隆间骨折患者122例,将按照随机数字表法将患者分为对照组和研究组,各61例。两组均采用封闭/开放复位PFNA内固定治疗,研究组给予鲑鱼降钙素注射液以及600 mg的钙尔奇D,对照组仅给予600 mg的钙尔奇D。术后随访12个月,观察比较两组的骨疼痛缓解情况、腰椎和健侧髋关节的骨密度(BMD)变化、骨痂出现时间、骨折愈合时间、髋关节功能和生活质量。结果:治疗后1~5个月,所有患者骨折均愈合,无股骨头坏死。治疗后12个月,研究组的骨痂出现时间、骨折愈合时间均短于对照组(P<0.05);两组的骨痛症状均较治疗前明显减轻(P<0.01);研究组髋关节的优良率高于对照组(P<0.05);研究组的OQOLS评分高于对照组(P<0.05);两组的L1~4、股骨颈及股骨大转子的骨密度与治疗前比较,差异均有统计学意义(P<0.05),研究组的上述指标均优于对照组,差异均有统计学意义(P<0.01)。结论:对于老年股骨粗隆间骨折,在PFNA内固定术的基础上结合抗骨质疏松药物治疗比单纯应用PFNA内固定术更能有效缓解骨疼痛,增加骨密度,促进骨折愈合,提高生活质量。更多还原

【Abstract】 Objective:To explore the clinical effect of proximal femoral nail antirotation(PFNA) and anti-osteoporosis drugs in elderly patients with femoral intertrochanteric fracture.Method:A total of 122 elderly patients with femoral intertrochanteric fracture in our hospital from January 2010 to December 2015 were selected and divided into the study group and the control group according to random number table method,61 cases in each group.Both groups were treated with the closed/open fixation of PFNA,the study group was taken with salmon calcitonin acetate injection and caltrate D(600 mg),the control group was just taken with caltrate D(600 mg).After 12 months follow-up,the pain relief and BMD of lumbar vertebrae and contralateral hip joint,the average appearance time of callus and average healing time,the clinical effect and life quality of the two groups were observed and compared.Result:1-5 months after treatment,all fractures healed without avascular necrosis of the femoral head.12 months after the treatment,the bone callus time and fracture healing time of the study group were shorter than those of the control group(P<0.05);the symptoms of bone pain in the two groups were significantly lower than those before treatment(P<0.01);the excellent rate of hip joint in the study group was higher than that in the control group(P<0.05);the OQOLS score of the study group was higher than that of the control group(P<0.05);the bone mineral density of the two groups of L1-4,femoral neck and greater trochanter of femur compared with before treatment,the differences were statistically significant(P<0.05),the above indicators in the study group were better than the control group,the difference was statistically significant(P<0.01).Conclusion:For the elderly femoral intertrochanteric fractures,PFNA internal fixation in based on the combination of anti osteoporosis drug treatment is more effective than the simple application of PFNA internal fixation can relieve bone pain,increase bone density,promote fracture healing, improve the quality of life.更多还原