CAJ | 학술논문

比较股骨近端防旋髓内钉（PFNA）、动力髋螺钉（DHS）与人工股骨头置换术（FHR）治疗老年股骨粗隆间骨折的临床疗效。对2005年6月～2012年6月收治且获得随访的65例老年股骨粗隆间骨折患者进行回顾性分析，其中男27例，女38例。根据治疗方式不同分为三组：PFNA 组21例，DHS 组22例，FHR 组22例。比较三组患者手术时间、术中出血量、术后引流量、负重时间、术后并发症发生情况及术后3个月、6个月、12个月髋关节 Harris 评分等。结果65例患者均获随访12个月～24个月（平均12．0个月±3．4个月），三种方法中，手术时间及负重时间比较，FHR 组时间最短，差异有统计学意义（P＜0．05）；术中出血量比较，DHS 组最少，差异有统计学意义（P＜0．05）；髋关节功能比较，FHR 组优于PFNA 组及 DHS 组，差异有统计学意义（P＜0．05）；术后引流量及术后并发症三组比较差异无统计学意义（P ＞0．05）。因此，对老年股骨粗隆间骨折患者，采用 FHR 手术可使患者术后早期下床，改善患者生活质量。
비교고골근단방선수내정（PFNA）、동력관라정（DHS）여인공고골두치환술（FHR）치료노년고골조륭간골절적림상료효。대2005년6월～2012년6월수치차획득수방적65례노년고골조륭간골절환자진행회고성분석，기중남27례，녀38례。근거치료방식불동분위삼조：PFNA 조21례，DHS 조22례，FHR 조22례。비교삼조환자수술시간、술중출혈량、술후인류량、부중시간、술후병발증발생정황급술후3개월、6개월、12개월관관절 Harris 평분등。결과65례환자균획수방12개월～24개월（평균12．0개월±3．4개월），삼충방법중，수술시간급부중시간비교，FHR 조시간최단，차이유통계학의의（P＜0．05）；술중출혈량비교，DHS 조최소，차이유통계학의의（P＜0．05）；관관절공능비교，FHR 조우우PFNA 조급 DHS 조，차이유통계학의의（P＜0．05）；술후인류량급술후병발증삼조비교차이무통계학의의（P ＞0．05）。인차，대노년고골조륭간골절환자，채용 FHR 수술가사환자술후조기하상，개선환자생활질량。
To compare the effectiveness of the proximal femoral nail anti-rotation (PFNA) ,dynamic hip screw (DHS) and femoral head prosthetic replacement (FHR) in treatment of intertrochanteric fractures from June 2005 to June 2012 ,were followed , treated and were retrospectively analyzed .Based on the treatments ,they were divided into three groups :21 patients were treated by PFNA ,22 patients were treated by DHS ,and 22 patients were treated by FHR .The study was to compare the outcomes of the three methods'operation time ,perioperative blood loss ,postoperative drainage ,weight bearing time ,postoperative complications and Harris score of three months ,six months and twelve months .The patients were all followed up for 12 to 24 mouths (averaged 12 .0 mouths ± 3 .4 mouths) .The operation and weight bearing time ,the group of FHR was shortest ,and the difference was statistically significant ( P < 0 .05 ) ; the perioperative blood loss ,DHS group was least ,and the difference was statistically significant (P< 0 .05) ,the hip function of FHR group was better than the PFNA group and DHS group ,the difference was statistically significant (P< 0 .05) ,postoperative drainage and postoperative complications were no statistical significance in three groups ( P > 0 .05 ) . Among elderly patients with intertrochanteric fractures , patients treated with FHR could have early ambulation and improve the quality of life after operation .