CAJ | 학술논문

目的：比较股骨近端防旋髓内钉（ PFNA）与人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折的临床疗效。方法将72例不稳定型股骨粗隆间骨折患者采用数字表法随机分为两组，每组各36例，其中对照组实施人工股骨头置换术，观察组采取PFNA内固定治疗，比较两组临床治疗效果。结果两组手术时间差异无统计学意义（t＝2．58，P＞0．05）。观察组术中出血量为（187．52±10．83）mL，较对照组少（t＝9．56，P＜0．05）；下地负重时间为（33．52±3．28）d，较对照组长（t＝10．31，P＜0．05）；观察、比较两组患者术后1年髋关节功能优良率（94．44％比91．67％）和术后并发症发生率（11．11％比8．33％）差异均无统计学意义（χ2＝2．01，1．69，均P＞0．05）。结论 PFNA内固定与人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折均有较好的疗效，临床应根据患者情况，在严格掌握手术禁忌证的情况下选择合适的手术方式。
목적：비교고골근단방선수내정（ PFNA）여인공고골두치환술치료고령불은정형고골조륭간골절적림상료효。방법장72례불은정형고골조륭간골절환자채용수자표법수궤분위량조，매조각36례，기중대조조실시인공고골두치환술，관찰조채취PFNA내고정치료，비교량조림상치료효과。결과량조수술시간차이무통계학의의（t＝2．58，P＞0．05）。관찰조술중출혈량위（187．52±10．83）mL，교대조조소（t＝9．56，P＜0．05）；하지부중시간위（33．52±3．28）d，교대조조장（t＝10．31，P＜0．05）；관찰、비교량조환자술후1년관관절공능우량솔（94．44％비91．67％）화술후병발증발생솔（11．11％비8．33％）차이균무통계학의의（χ2＝2．01，1．69，균P＞0．05）。결론 PFNA내고정여인공고골두치환술치료고령불은정형고골조륭간골절균유교호적료효，림상응근거환자정황，재엄격장악수술금기증적정황하선택합괄적수술방식。
Objective To compare the clinical efficacy of proximal femoral nail anti-rotation ( PFNA ) fixation and hemiarthroplasty in the treatment of elderly unstable intertrochanteric fractures .Methods 72 cases with unstable intertrochanteric fractures were divided into the two groups by random number table ,each group had 36 ca-ses,the control group was given implementation of hemiarthroplasty while the observation group was given PFNA fixa -tion,the clinical therapeutic effect were compared between the two groups .Results It showed no significant differ-ence in operative time between the two groups (t =2.58,P>0.05);the blood loss of the observation group was (187.52 ±10.83)mL,which was significantly less than that of the control group (t=9.56,P<0.05),the load time of the observation group was (33.52 ±3.28)d,which was significantly more than that of the control group (t=10.31, P<0.05);there were no significant differences in the hip function excellent rate after 1 year and postoperative com-plication rate between the two groups (94.44% or 91.67%,11.11% or 8.33%,χ2 =2.01,1.69,all P>0.05). Conclusion PFNA fixation and hemiarthroplasty for treatment in elderly unstable intertrochanteric fractures have good effect ,and the patients should be based on the specific clinical circumstances , under strict control of surgical contraindications choose the right surgery .