CAJ | 학술논문

目的：探讨术前慢性病对股骨近端髓内钉(PFN)内固定治疗老年股骨粗隆间骨折疗效的影响。方法回顾性分析我院2008年1月至2013年5月收治的诊断为股骨粗隆间骨折并采用PFN内固定治疗的286例高龄患者的临床资料，根据术前是否有慢性病将其分为两组，A组96例，术前无慢性病，B组190例，术前患有慢性病，比较两组患者的围手术期失血量、术后3、6、12个月术侧髋关节Harris评分及术后并发症发生情况。结果 B组患者围手术期失血总量、显性失血量、隐性失血量均高于A组(P<0.05)；A组在术后3个月、6个月、12个月的Harris髋关节功能评分均明显高于B组(P<0.05)，术后并发症发生率B组明显高于A组(P<0.05)。结论术前合并慢性病会对股骨PFN内固定治疗老年股骨粗隆间骨折疗效造成影响，因此术前合并慢性病者要综合评估，加强处理，积极治疗可预防并发症的发生。
목적：탐토술전만성병대고골근단수내정(PFN)내고정치료노년고골조륭간골절료효적영향。방법회고성분석아원2008년1월지2013년5월수치적진단위고골조륭간골절병채용PFN내고정치료적286례고령환자적림상자료，근거술전시부유만성병장기분위량조，A조96례，술전무만성병，B조190례，술전환유만성병，비교량조환자적위수술기실혈량、술후3、6、12개월술측관관절Harris평분급술후병발증발생정황。결과 B조환자위수술기실혈총량、현성실혈량、은성실혈량균고우A조(P<0.05)；A조재술후3개월、6개월、12개월적Harris관관절공능평분균명현고우B조(P<0.05)，술후병발증발생솔B조명현고우A조(P<0.05)。결론술전합병만성병회대고골PFN내고정치료노년고골조륭간골절료효조성영향，인차술전합병만성병자요종합평고，가강처리，적겁치료가예방병발증적발생。
Objective To investigate and evaluate the effect of preoperative chronic disease on internal fixa-tion with proximal femoral nails (PFN) in the treatment of elderly intertrochanteric femoral fracture. Methods A ret-rospective analysis of 286 elderly patients diagnosed as intertrochanteric femoral fractures and treated with PFN in our hospital from January 2008 to May 2013 was conducted, which were divided into two groups according to the presence of preoperative chronic disease. Patients of group A (n=96) did not had preoperative chronic disease, while patients of group B (n=190) had preoperative chronic disease group. The blood loss during the operation, hip Harris score and postoperative complications 3, 6, 12 months after the operation were compared between the two groups. Results The total blood loss, dominant blood loss, hidden blood loss and the operation period of patients in group B were significantly higher than those in group A (P<0.05). Harris hip joint function 3 months, 6 months, 12 months after operation of group A were significantly higher than those of group B (P<0.05), and the occurrence rate of postoperative complications in group B was significantly higher than that in group A. Conclusion Preoperative chronic disease can influence the curative effect of PFN internal fixation in treatment of intertrochanteric femoral frac-tures. Therefore, patients with preoperative chronic diseases should be comprehensively assessed and actively treated to prevent complications.