中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
21期
19-22
,共4页
刘景锋%冯永洪%卢国樑%肖署阳
劉景鋒%馮永洪%盧國樑%肖署暘
류경봉%풍영홍%로국량%초서양
股骨粗隆间骨折%骨质疏松%唑来膦酸
股骨粗隆間骨摺%骨質疏鬆%唑來膦痠
고골조륭간골절%골질소송%서래련산
Femoral intertrochanteric fractures%Osteoporosis%Zoledronic acid
目的：观察应用唑来膦酸对老年骨质疏松性股骨粗隆间骨折临床疗效的影响。方法：将本院2012年1月-2014年1月采用闭合复位髓内钉固定术治疗的64例骨质疏松性粗隆间骨折患者按照随机数字表法分为治疗组34例和对照组30例。其中治疗组应用唑来膦酸进行治疗，对照组未应用唑来膦酸进行治疗。观察比较两组患者术前及术后1年的骨密度值、Harris髋关节功能评分、骨折愈合时间和再次骨折发生率。结果：治疗组的骨折愈合时间和Harris评分分别为（12.14±1.38）周、（89.42±4.82）分；对照组分别为（13.86±1.76）周、（88.54±4.54）分，两组比较差异均无统计学意义（P>0.05）。术后1年治疗组骨密度平均为（0.728±0.134）g/cm2明显高于对照组的（0.542±0.138）g/cm2，且治疗组术后1年与术前骨密度比较差异有统计学意义（P<0.05），对照组术后1年与术前骨密度比较差异无统计学意义（P>0.05）。治疗组再次骨折发生率5.8%明显低于对照组的20.0%，比较差异有统计学意义（P<0.05）。结论：老年骨质疏松性股骨粗隆间骨折内固定术后应用唑来膦酸能明显升高患者骨密度，预防患者再次骨折的发生，值得临床推广。
目的：觀察應用唑來膦痠對老年骨質疏鬆性股骨粗隆間骨摺臨床療效的影響。方法：將本院2012年1月-2014年1月採用閉閤複位髓內釘固定術治療的64例骨質疏鬆性粗隆間骨摺患者按照隨機數字錶法分為治療組34例和對照組30例。其中治療組應用唑來膦痠進行治療，對照組未應用唑來膦痠進行治療。觀察比較兩組患者術前及術後1年的骨密度值、Harris髖關節功能評分、骨摺愈閤時間和再次骨摺髮生率。結果：治療組的骨摺愈閤時間和Harris評分分彆為（12.14±1.38）週、（89.42±4.82）分；對照組分彆為（13.86±1.76）週、（88.54±4.54）分，兩組比較差異均無統計學意義（P>0.05）。術後1年治療組骨密度平均為（0.728±0.134）g/cm2明顯高于對照組的（0.542±0.138）g/cm2，且治療組術後1年與術前骨密度比較差異有統計學意義（P<0.05），對照組術後1年與術前骨密度比較差異無統計學意義（P>0.05）。治療組再次骨摺髮生率5.8%明顯低于對照組的20.0%，比較差異有統計學意義（P<0.05）。結論：老年骨質疏鬆性股骨粗隆間骨摺內固定術後應用唑來膦痠能明顯升高患者骨密度，預防患者再次骨摺的髮生，值得臨床推廣。
목적：관찰응용서래련산대노년골질소송성고골조륭간골절림상료효적영향。방법：장본원2012년1월-2014년1월채용폐합복위수내정고정술치료적64례골질소송성조륭간골절환자안조수궤수자표법분위치료조34례화대조조30례。기중치료조응용서래련산진행치료，대조조미응용서래련산진행치료。관찰비교량조환자술전급술후1년적골밀도치、Harris관관절공능평분、골절유합시간화재차골절발생솔。결과：치료조적골절유합시간화Harris평분분별위（12.14±1.38）주、（89.42±4.82）분；대조조분별위（13.86±1.76）주、（88.54±4.54）분，량조비교차이균무통계학의의（P>0.05）。술후1년치료조골밀도평균위（0.728±0.134）g/cm2명현고우대조조적（0.542±0.138）g/cm2，차치료조술후1년여술전골밀도비교차이유통계학의의（P<0.05），대조조술후1년여술전골밀도비교차이무통계학의의（P>0.05）。치료조재차골절발생솔5.8%명현저우대조조적20.0%，비교차이유통계학의의（P<0.05）。결론：노년골질소송성고골조륭간골절내고정술후응용서래련산능명현승고환자골밀도，예방환자재차골절적발생，치득림상추엄。
To observe the clinical effect of zoledronic acid in treatment of the senile osteoporotic femoral intertrochanteric fractures.Method:64 cases of osteoporotic femoral intertrochanteric fractures with closed reduction and intramedullary nail fixation from January 2012 to January 2014 were randomly divided into the treatment group for 34 cases and the control group for 30 cases.The treatment group was treated with zoledronic acid,the control group was not treated with zoledronic acid.The BMD,Harris hip function score,fracture healing time and refracture rate before and post operation 1 year later of the two groups were observed and compared.Result:The healing time of fracture and Harris score of patients in the treatment group were(12.14±1.38)weeks,(89.42±4.82)scores;which in the control group were(13.86±1.76)weeks,(88.54±4.54)scores,there were no significant differences in the two groups (P>0.05).The bone mineral density of the treatment group during 1 year of treatment later was(0.728±0.134)g/cm2,it was significantly higher than(0.542±0.138)g/cm2 in the control group.Those change were significant difference for the treatment group but no significant difference for the control group.The refracture occurrence rate of the treatment group was 5.8%,it was significantly lower than 20.0%of the control group. the difference was statistically significant(P<0.05). Conclusion:Zoledronic acid can significantly increase the bone density of patients which have senile osteoporotic intertrochanteric fracture after internal fixation,and it can prevent the occurrence of refracture open again,is worthy of clinical promotion.
