【摘要】 目的 研究防旋型股骨近端髓内钉（PFNA）内固定术对老年股骨转子间骨折（IFF）患者的疗效及对生物力学性能的影响。方法 选取2020年10月至2023年10月龙岩市第二医院收治的112例老年IFF患者开展研究，以随机数字表法将其分作PFNA组（n=56）及对照组（n=56）。PFNA组选用PFNA内固定术治疗，对照组则选用股骨近端锁定钢板内固定（PFLCP）治疗。对比两组手术相关指标、生物力学性能、髋关节功能、创伤应激指标。结果 PFNA组手术时长、术中失血量、下地负重时间、骨折愈合时间及住院天数均低于对照组（均P<0.05）。PFNA组扭转1.5°扭转刚度、扭转1.5°扭矩、载荷800 N压缩刚度及载荷800 N压缩位移均优于对照组（均P<0.05）。PFNA组术后1、3、6个月Harris髋关节评分系统（HHS）评分均高于对照组（均P<0.05）。术后3 d两组去甲肾上腺素（NE）与血管紧张素Ⅱ（AngⅡ）水平均高于术前，但PFNA组低于对照组（均P<0.05）。结论 PFNA内固定术治疗老年IFF的疗效较佳，且能改善生物力学性能，减轻创伤应激反应。更多还原

【Abstract】 Objective To study the efficacy and biomechanical properties of proximal femoral nail anti-rotatio(PFNA) fixation in elderly patients with intertrochanteric fracture(IFF). Methods A total of 112 elderly patients with IFF treated in the second hospital of Longyan from October 2020 to October 2023 were studied. They were divided into PFNA group(n=56) and control group(n=56) by random number table method. PFNA group was treated with PFNA internal fixation, while control group was treated with proximal femur locking compression plate(PFLCP). The operation related indexes, biomechanical properties, hip function and traumatic stress index were compared between the two groups. Results Operation duration, intraoperative blood loss, weight-bearing time, fracture healing time and hospitalization days in PFNA group were lower than those in control group(all P<0.05). The 1.5° torsional stiffness, 1.5° torsional torque, 800N compression stiffness and 800N compression displacement in PFNA group were better than those in control group(all P<0.05). The Harris Hip Scoring System(HHS) scores of PFNA group at 1 month, 3 months and 6 months after operation were higher than those of control group(all P<0.05). The levels of norepinephrine(NE) and angiotensin Ⅱ(AngⅡ) in both groups were higher than those before surgery, but those in PFNA group were lower than those in control group(all P<0.05). Conclusions PFNA internal fixation is effective in the treatment of senile IFF, and can improve biomechanical properties and alleviate traumatic stress response.更多还原