西南国防医药
西南國防醫藥
서남국방의약
MEDICAL JOURNAL OF NATIONAL DEFENDING FORCES IN SOUTHWEST CHINA
2014年
7期
732-735
,共4页
谭云%许将兴%陈乾刚%朱政炜
譚雲%許將興%陳乾剛%硃政煒
담운%허장흥%진건강%주정위
股骨近端短重建钉%髓内加压螺钉%转子间骨折%临床疗效
股骨近耑短重建釘%髓內加壓螺釘%轉子間骨摺%臨床療效
고골근단단중건정%수내가압라정%전자간골절%림상료효
proximal femoral nail(PFN)%intramedullary hip screw(IMHS)%intertrochanteric fracture%clinical effect
目的：比较髓内加压螺钉（IMHS）和近端短重建钉（PFN）治疗股骨转子间骨折的效果。方法64例股骨转子间骨折患者分为两组，分别采用 IMHS 与 PFN 治疗；对比两组手术时间、输血量、行走能力、并发症、病死率等。结果 IMHS组与 PFN 组手术时间分别为（52.56±12.63）min 与（54.74±14.85）min，平均输血量为（1.68±0.31）U 与（1.79±0.27）U，术后血红蛋白水平分别为（96.34±16.36）g/ L、（97.75±15.87）g/ L，两组间上述指标无明显差异（P ﹥0.05）。IMHS 组与 PFN组术后独立步行、辅助步行、不能步行例数分别为10例（31.25％）、17例（53.13％）、5例（15.63％）与8例（25.00％）、14例（43.75％）、10例（31.25％）；IMHS 组行走能力优于 PFN 组（P ﹤0.05）。PFN 组并发症发生率（34.38％）高于 IMHS 组的6.26％（P ﹤0.05），不稳定型患者并发症（21.88％）高于 IMHS 组的3.13％（P ﹤0.05）。结论 IMHS 比 PFN 能提供更稳定的内固定，并发症率较低，更适合应用于不稳定型的转子间骨折。
目的：比較髓內加壓螺釘（IMHS）和近耑短重建釘（PFN）治療股骨轉子間骨摺的效果。方法64例股骨轉子間骨摺患者分為兩組，分彆採用 IMHS 與 PFN 治療；對比兩組手術時間、輸血量、行走能力、併髮癥、病死率等。結果 IMHS組與 PFN 組手術時間分彆為（52.56±12.63）min 與（54.74±14.85）min，平均輸血量為（1.68±0.31）U 與（1.79±0.27）U，術後血紅蛋白水平分彆為（96.34±16.36）g/ L、（97.75±15.87）g/ L，兩組間上述指標無明顯差異（P ﹥0.05）。IMHS 組與 PFN組術後獨立步行、輔助步行、不能步行例數分彆為10例（31.25％）、17例（53.13％）、5例（15.63％）與8例（25.00％）、14例（43.75％）、10例（31.25％）；IMHS 組行走能力優于 PFN 組（P ﹤0.05）。PFN 組併髮癥髮生率（34.38％）高于 IMHS 組的6.26％（P ﹤0.05），不穩定型患者併髮癥（21.88％）高于 IMHS 組的3.13％（P ﹤0.05）。結論 IMHS 比 PFN 能提供更穩定的內固定，併髮癥率較低，更適閤應用于不穩定型的轉子間骨摺。
목적：비교수내가압라정（IMHS）화근단단중건정（PFN）치료고골전자간골절적효과。방법64례고골전자간골절환자분위량조，분별채용 IMHS 여 PFN 치료；대비량조수술시간、수혈량、행주능력、병발증、병사솔등。결과 IMHS조여 PFN 조수술시간분별위（52.56±12.63）min 여（54.74±14.85）min，평균수혈량위（1.68±0.31）U 여（1.79±0.27）U，술후혈홍단백수평분별위（96.34±16.36）g/ L、（97.75±15.87）g/ L，량조간상술지표무명현차이（P ﹥0.05）。IMHS 조여 PFN조술후독립보행、보조보행、불능보행례수분별위10례（31.25％）、17례（53.13％）、5례（15.63％）여8례（25.00％）、14례（43.75％）、10례（31.25％）；IMHS 조행주능력우우 PFN 조（P ﹤0.05）。PFN 조병발증발생솔（34.38％）고우 IMHS 조적6.26％（P ﹤0.05），불은정형환자병발증（21.88％）고우 IMHS 조적3.13％（P ﹤0.05）。결론 IMHS 비 PFN 능제공경은정적내고정，병발증솔교저，경괄합응용우불은정형적전자간골절。
Objective To investigate the therapeutic effect of intramedullary hip screw(IMHS)and proximal femoral nail (PFN)for intertrochanteric fracture. Methods 64 patients with intertrochanteric fracture were randomly divided into 2 groups:IMHS group and PFN group,32 cases in each,and IMHS and PFN were used in the operation,respectively;certain data of the operations and the effect were observed and a comparative study was made between the 2 groups. Results The operations lasted averagely for (52. 56 ± 12. 63)minutes in IMHS group and(54. 74 ± 14. 85)minutes in PFN group;the average amount of blood transfusion in operation was(1. 68 ± 0. 31)U in IMHS group and(1. 79 ± 0. 27)U in PFN group;the postoperative haemoglobin level of the patients was(96. 34 ± 16. 36)g/ L in IMHS group and(97. 75 ± 15. 87)g/ L in PFN group;there were no significant differences in above indexes between the two groups(P ﹥ 0. 05);in IMHS group,10 cases(31. 25% )could walk independently,17 cases(53. 13% )could walk with assistive device,and 5 cases(15. 63% )failed to walk;while in PFN group,8 cases(25. 00% )could walk independently,14 cases(43. 75% )could walk with assistive device,and 10 cases(31. 25% )failed to walk;the Parker-Palmer score of the patients in IMHS group was higher than that of the patients in PFN group(P ﹤ 0. 05);the occurrence of complications in PFN group(34. 38% ) was significantly higher than that in IMHS group of 6. 26%(P ﹤ 0. 05);the occurrence of complications in patients with unstable intertrochanteric fracture was 21. 88% in PFN group and 3. 13% in IMHS group(P ﹤ 0. 05). Conclusions IMHS provides a more stable internal fixation with a lower occurrence of complications than PFN;it is more suitable to be applied to patients with unstable intertrochanteric fracture.
