中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
12期
2256-2259
,共4页
骨质疏松%利塞膦酸钠%股骨粗隆间骨折
骨質疏鬆%利塞膦痠鈉%股骨粗隆間骨摺
골질소송%리새련산납%고골조륭간골절
Osteoporosis%Risedronate sodium%Intertrochanteric fracture
目的：比较应用股骨近端防旋髓内钉（PFNA）联合利塞磷酸钠与单纯行PFNA治疗骨质疏松性股骨粗隆间骨折的临床疗效。方法前瞻性研究2011年1月至2013年4月，采用PFNA治疗62例老年股骨转子间骨折患者资料。术前随机将患者分为利塞膦酸钠组（PFNA治疗联合应用利塞膦酸钠）和对照组（单纯PFNA治疗）。利塞膦酸钠组32例，男15例，女17例；年龄70～85岁，平均78岁；按AO分型，A1型10例，A2型18例；A3型4例。对照组30例，男13例，女17例；年龄68～84岁，平均77.5岁；按AO分型，A1型9例，A2型16例；A3型5例。两组患者分别比较术前及术后1年骨密度值。采用Harris评分评价髋关节功能，记录手术相关并发症、药物不良反应及其他部位骨折等情况。结果60例患者获得1年以上的完整随访，利塞膦酸钠组30例，对照组30例。术后6个月复查时，所有患者骨折均愈合。术前利塞膦酸钠组健侧髋部平均骨密度T值为-2.58±0.41，对照组为-2.56±0.36；术后1年利塞膦酸钠组健侧髋部平均骨密度T值分别为-0.66±0.37，对照组为-1.13±0.28，差异有统计学意义（P＝0.000）。术后两组患者Harris评分比较，差异无统计学意义（P＝0.238）。利塞膦酸钠组随访期间无再发骨折，对照组1例发生腰椎压缩性骨折，1例发生桡骨远端骨折，2例发生健侧髋部骨折。结论骨质疏松性粗隆间骨折术后早期服用利塞膦酸钠不影响骨折愈合，并可提高健髋骨密度。
目的：比較應用股骨近耑防鏇髓內釘（PFNA）聯閤利塞燐痠鈉與單純行PFNA治療骨質疏鬆性股骨粗隆間骨摺的臨床療效。方法前瞻性研究2011年1月至2013年4月，採用PFNA治療62例老年股骨轉子間骨摺患者資料。術前隨機將患者分為利塞膦痠鈉組（PFNA治療聯閤應用利塞膦痠鈉）和對照組（單純PFNA治療）。利塞膦痠鈉組32例，男15例，女17例；年齡70～85歲，平均78歲；按AO分型，A1型10例，A2型18例；A3型4例。對照組30例，男13例，女17例；年齡68～84歲，平均77.5歲；按AO分型，A1型9例，A2型16例；A3型5例。兩組患者分彆比較術前及術後1年骨密度值。採用Harris評分評價髖關節功能，記錄手術相關併髮癥、藥物不良反應及其他部位骨摺等情況。結果60例患者穫得1年以上的完整隨訪，利塞膦痠鈉組30例，對照組30例。術後6箇月複查時，所有患者骨摺均愈閤。術前利塞膦痠鈉組健側髖部平均骨密度T值為-2.58±0.41，對照組為-2.56±0.36；術後1年利塞膦痠鈉組健側髖部平均骨密度T值分彆為-0.66±0.37，對照組為-1.13±0.28，差異有統計學意義（P＝0.000）。術後兩組患者Harris評分比較，差異無統計學意義（P＝0.238）。利塞膦痠鈉組隨訪期間無再髮骨摺，對照組1例髮生腰椎壓縮性骨摺，1例髮生橈骨遠耑骨摺，2例髮生健側髖部骨摺。結論骨質疏鬆性粗隆間骨摺術後早期服用利塞膦痠鈉不影響骨摺愈閤，併可提高健髖骨密度。
목적：비교응용고골근단방선수내정（PFNA）연합리새린산납여단순행PFNA치료골질소송성고골조륭간골절적림상료효。방법전첨성연구2011년1월지2013년4월，채용PFNA치료62례노년고골전자간골절환자자료。술전수궤장환자분위리새련산납조（PFNA치료연합응용리새련산납）화대조조（단순PFNA치료）。리새련산납조32례，남15례，녀17례；년령70～85세，평균78세；안AO분형，A1형10례，A2형18례；A3형4례。대조조30례，남13례，녀17례；년령68～84세，평균77.5세；안AO분형，A1형9례，A2형16례；A3형5례。량조환자분별비교술전급술후1년골밀도치。채용Harris평분평개관관절공능，기록수술상관병발증、약물불량반응급기타부위골절등정황。결과60례환자획득1년이상적완정수방，리새련산납조30례，대조조30례。술후6개월복사시，소유환자골절균유합。술전리새련산납조건측관부평균골밀도T치위-2.58±0.41，대조조위-2.56±0.36；술후1년리새련산납조건측관부평균골밀도T치분별위-0.66±0.37，대조조위-1.13±0.28，차이유통계학의의（P＝0.000）。술후량조환자Harris평분비교，차이무통계학의의（P＝0.238）。리새련산납조수방기간무재발골절，대조조1례발생요추압축성골절，1례발생뇨골원단골절，2례발생건측관부골절。결론골질소송성조륭간골절술후조기복용리새련산납불영향골절유합，병가제고건관골밀도。
ObjectiveTo compare the clinical outcomes between proximal femoral nail antirotation(PFNA) combined withrisedronate sodium and PFNA only for the treatment of intertrochanteric fractures in elderly patients.Methods From January 2011 to April 2013, 62 elderly patients with intertrochanteric fracture were randomly divided into two groups: risedronate sodium group and control group. Patients in risedronate sodium group were treated with PFNA combined with risedronate sodium, while patients in control group were treated with PFNA only. According to AO classification, 32 patients in risedronate sodium group(15 males and 17 females, with an average age of 78 years) were divided into 10 cases of typeⅠ, 18 cases of typeⅡ and 4 typeⅢ. 30 patients in control group (13 males and 17 females, with an average age of 77.5 years) were divided into 9 cases of typeⅠ, 16 cases of typeⅡ and 5 cases of typeⅢ. Bone healing was assessed with X-ray and bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. Harris hip score, complications,adverse effect of risedronate sodium and subsequent second fractures other than the initial one were evaluated postoperatively. Results 60 patients were followed up for at least one year. All fractures were healed in 6 months after surgery. No significant difference was found between the two groups in BMD preoperatively. The changes in BMD were significantly different between the two groups in one year after surgery. No significant difference was found between the two groups in Harris hip score. NO patient in risedronate group who suffered from subsequent second fractures other than the initial one after surgery, while there was 4 patients in control group postoperatively.Conclusion Early administration by risedronate does not affect the rate of healing of an intertrochanteric fracture and it could increase BMD.
