中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2014年
11期
910-913
,共4页
陈来%刘林%叶灵超%洪华兴%张德清
陳來%劉林%葉靈超%洪華興%張德清
진래%류림%협령초%홍화흥%장덕청
股骨骨折%内固定器%锁定加压钢板%骨折固定术,髓内
股骨骨摺%內固定器%鎖定加壓鋼闆%骨摺固定術,髓內
고골골절%내고정기%쇄정가압강판%골절고정술,수내
Femoral fractures%Internal fixators%Locking compression plate%Fracture fixation,intramedullary
目的 比较股骨近端锁定钢板(LPFP)与股骨近端髓内钉-螺旋刀片(PFNA)微创内固定治疗60岁以上股骨转子间骨折的优缺点.方法 观察自2010年1月至2013年6月选用LPFP治疗的69例(LPEP组)和选用PFNA治疗的61例(PFNA组)患者的手术时间、术中X线透视次数、术中失血量、术后引流量、术后Hb下降水平、术后并发症、住院费用、骨折愈合时间、术后髋关节Hariss功能评分等情况,并行两组比较.结果 LPFP和PFNA组的术中出血量为(132 ±95)和(110 ±79)ml、术后引流量为(44±16)和(41±17)ml、术后Hb下降了(2.3±0.9)和(2.5±1.2)g/L、骨折愈合时间为(10.5±1.0)和(10.4±1.5)周、术后髋关节Hariss功能评分为(87±10)和(90 ±8)分,两组比较差异无统计学意义(均P＞0.05);术中X线透视次数LPFP组(8.1±0.8)次、PFNA组(8.6±0.9)次,住院费用LPFP组(14 911±1 908)元、PFNA组(21 908 ±2 928)元,手术时间LPFP组(60±11)min、PFNA组(51±14)min,术后并发症发生率LPFP组10％ (7/69)、PFNA组26％(16/61),LPFP组在术中X线透视次数、住院费用、术后并发症发生率方面优于PFNA组(t值分别为3.33和15.91,x2=5.72,均P＜0.01),PFNA组的手术时间短于LPFP组,差异有统计学意义(t=4.04,P＜0.01).结论 对于60岁以上股骨转子间骨折,LPFP可能是更好的选择.
目的 比較股骨近耑鎖定鋼闆(LPFP)與股骨近耑髓內釘-螺鏇刀片(PFNA)微創內固定治療60歲以上股骨轉子間骨摺的優缺點.方法 觀察自2010年1月至2013年6月選用LPFP治療的69例(LPEP組)和選用PFNA治療的61例(PFNA組)患者的手術時間、術中X線透視次數、術中失血量、術後引流量、術後Hb下降水平、術後併髮癥、住院費用、骨摺愈閤時間、術後髖關節Hariss功能評分等情況,併行兩組比較.結果 LPFP和PFNA組的術中齣血量為(132 ±95)和(110 ±79)ml、術後引流量為(44±16)和(41±17)ml、術後Hb下降瞭(2.3±0.9)和(2.5±1.2)g/L、骨摺愈閤時間為(10.5±1.0)和(10.4±1.5)週、術後髖關節Hariss功能評分為(87±10)和(90 ±8)分,兩組比較差異無統計學意義(均P＞0.05);術中X線透視次數LPFP組(8.1±0.8)次、PFNA組(8.6±0.9)次,住院費用LPFP組(14 911±1 908)元、PFNA組(21 908 ±2 928)元,手術時間LPFP組(60±11)min、PFNA組(51±14)min,術後併髮癥髮生率LPFP組10％ (7/69)、PFNA組26％(16/61),LPFP組在術中X線透視次數、住院費用、術後併髮癥髮生率方麵優于PFNA組(t值分彆為3.33和15.91,x2=5.72,均P＜0.01),PFNA組的手術時間短于LPFP組,差異有統計學意義(t=4.04,P＜0.01).結論 對于60歲以上股骨轉子間骨摺,LPFP可能是更好的選擇.
목적 비교고골근단쇄정강판(LPFP)여고골근단수내정-라선도편(PFNA)미창내고정치료60세이상고골전자간골절적우결점.방법 관찰자2010년1월지2013년6월선용LPFP치료적69례(LPEP조)화선용PFNA치료적61례(PFNA조)환자적수술시간、술중X선투시차수、술중실혈량、술후인류량、술후Hb하강수평、술후병발증、주원비용、골절유합시간、술후관관절Hariss공능평분등정황,병행량조비교.결과 LPFP화PFNA조적술중출혈량위(132 ±95)화(110 ±79)ml、술후인류량위(44±16)화(41±17)ml、술후Hb하강료(2.3±0.9)화(2.5±1.2)g/L、골절유합시간위(10.5±1.0)화(10.4±1.5)주、술후관관절Hariss공능평분위(87±10)화(90 ±8)분,량조비교차이무통계학의의(균P＞0.05);술중X선투시차수LPFP조(8.1±0.8)차、PFNA조(8.6±0.9)차,주원비용LPFP조(14 911±1 908)원、PFNA조(21 908 ±2 928)원,수술시간LPFP조(60±11)min、PFNA조(51±14)min,술후병발증발생솔LPFP조10％ (7/69)、PFNA조26％(16/61),LPFP조재술중X선투시차수、주원비용、술후병발증발생솔방면우우PFNA조(t치분별위3.33화15.91,x2=5.72,균P＜0.01),PFNA조적수술시간단우LPFP조,차이유통계학의의(t=4.04,P＜0.01).결론 대우60세이상고골전자간골절,LPFP가능시경호적선택.
Objective To compare the proximal femoral locking plate (LPFP) and proximal femoral intramedullary nail-spiral blade (PFNA) in minimally invasive internal fixation for elderly patients with intertrochanteric fractures.Methods One hundred and thirty patients aged over 60 years with intertrochanteric fractures were treated with minimally invasive internal fixation from January 2010 to June 2013,among them LPFP was applied in 69 cases and PFNA in 61 cases.The operation time,the numbers of intraoperative X-ray fluoroscopy,intraoperative blood loss,postoperative flow and decreased postoperative hemoglobin,postoperative complications,medical expenses,fracture healing time,postoperative hip Hariss function score were documented and compared between two groups.Results There were no significant differences in intraoperative blood loss [(132 ± 95) and (110 ± 79) ml],postoperative draining [(44 ± 16) and (41 ± 17) ml],decreased postoperative hemoglobin,fracture healing time [(10.5 ± 1.0) and (10.4 ± 1.5) weeks] and postoperative hip Hariss function score (87 ± 10 and 90 ± 8) between two groups.In LPFP group the number of intraoperative X-ray fluoroscopy (8.1 ±0.8 and 8.6 ± 0.9),hospitalization expenses,postoperative complications (7/69 and 16/61) were less than those in PFNA group (P＜0.05 or 0.01),however,the operation time was longer (P＜0.01).Conclusion LPFP may be a better choice in internal fixation for elderly patients with intertrochanteric fractures.
