CAJ | 학술논문

目的：探讨分析PFN内固定手术与人工股骨头置换术治疗老年高龄患者股骨转子间骨折的临床应用及价值。方法：选取本院2010年3月-2013年3月收治的58例股骨转子间骨折老年高龄患者，随机分为观察组与参考组各29例，给予参考组患者PFN内固定手术治疗，观察组患者行人工股骨头置换术，观察患者的术中出血量、手术时间、术后并发症发生率及完全负重时间，比较两组患者治疗3个月、1年后的Harris评分。结果：参考组患者手术时间及术中出血量及明显少于观察组组（P<0.05），参考组患者术后并发症发生率明显少于观察组（P<0.05）；观察组患者完全负重时间明显少于参考组（P<0.05）；治疗3个月后，观察组患者Harris评分与参考组比较差异有统计学意义（P<0.05）。治疗1年后，两组患者Harris评分差异无统计学意义。结论：相较人工股骨头置换，PFN内固定手术时间短且术中出血量少，术后并发症发生率明显较低，然而早期功能康复效果与人工股骨头置换有一定的差距，两种手术方式远期治疗效果差异无统计学意义。
목적：탐토분석PFN내고정수술여인공고골두치환술치료노년고령환자고골전자간골절적림상응용급개치。방법：선취본원2010년3월-2013년3월수치적58례고골전자간골절노년고령환자，수궤분위관찰조여삼고조각29례，급여삼고조환자PFN내고정수술치료，관찰조환자행인공고골두치환술，관찰환자적술중출혈량、수술시간、술후병발증발생솔급완전부중시간，비교량조환자치료3개월、1년후적Harris평분。결과：삼고조환자수술시간급술중출혈량급명현소우관찰조조（P<0.05），삼고조환자술후병발증발생솔명현소우관찰조（P<0.05）；관찰조환자완전부중시간명현소우삼고조（P<0.05）；치료3개월후，관찰조환자Harris평분여삼고조비교차이유통계학의의（P<0.05）。치료1년후，량조환자Harris평분차이무통계학의의。결론：상교인공고골두치환，PFN내고정수술시간단차술중출혈량소，술후병발증발생솔명현교저，연이조기공능강복효과여인공고골두치환유일정적차거，량충수술방식원기치료효과차이무통계학의의。
Objective:To investigate and analyze the PFN internal fixation operation and artificial femoral head replacement treatment of femoral intertrochanteric fracture in elderly patients with the clinical application and value. Method:58 cases with femur rotor in our hospital from 2010 March to 2013 March were fracture between elderly patients,randomly divided into observation group and reference group,29 cases in each group. To give the reference fixed operation in patients with PFN,and patients in the observation group underwent artificial femoral head replacement. Full weight bearing time,complication rate,and amount the operation time,bleeding,postoperative observation of patients were compared between the two groups 3 months, 1 years after the Harris score. Result:The operation time,bleeding volume,and reference complications of the reference group was less than that of the observation group(P<0.05). The full weight bearing time of the observation group was significantly less than that of the reference group(P<0.05). After 3 months of treatment,the observation group was significantly better than reference group(P<0.05),with statistical significance. After 1 years of treatment,there was no significant difference between the two groups,the Harris score had no statistical significance. Conclusion:Compared with artificial femoral head replacement,the PFN operation time shorter fixation and less blood loss in operation,and the postoperative complication rate is significantly lower,but the early rehabilitation effect of PFN internal fixation and hemiarthroplasty have a certain gap,two kinds of operation way forward no significant differences in treatment effects.