中国医药
中國醫藥
중국의약
China Medicine
2015年
11期
1641-1643
,共3页
骨质疏松症%股骨粗隆间骨折%抗旋转股骨近端髓内钉内固定术%阿仑膦酸钠%老年
骨質疏鬆癥%股骨粗隆間骨摺%抗鏇轉股骨近耑髓內釘內固定術%阿崙膦痠鈉%老年
골질소송증%고골조륭간골절%항선전고골근단수내정내고정술%아륜련산납%노년
Osteoporosis%Femoral intertrochanteric fractures%Proximal femoral nail anti-rotation%Alendronate%Elderly
目的 探讨抗旋转股骨近端髓内钉(PFNA)内固定联合阿仑膦酸钠治疗老年股骨粗隆间骨折的效果.方法 选择唐山市中医医院2010年1月至2014年1月收治的老年股骨粗隆间骨折患者57例,根据随机数字表法分为观察组(28例)与对照组(29例),2组均给予PFNA内固定治疗,术后均给予碳酸钙D3片600 mg,1次/d,口服.观察组术后2周给予阿仑膦酸钠70 mg口服,每周1次.2组疗程均为1年.观察2组患者手术相关并发症、骨折愈合时间、髋关节功能、抗骨质疏松治疗结束后L2~4椎体骨密度水平以及再骨折发生情况.结果 2组患者均未发生骨折不愈合或畸形愈合,无螺钉松动和伤口感染,未见脂肪栓塞、深静脉血栓等.观察组与对照组患者骨折愈合时间、髋关节功能比较,差异无统计学意义(P>0.05),骨密度比较[(0.79 ±0.10)g/cm2比(0.64 ±0.04)g/cm2],差异有统计学意义(P<0.05).术后随访10~20个月,观察组患者未见其他部位再骨折,对照组4例发生其他部位再骨折[0.0% (0/28)比13.8% (4/29)],2组比较差异有统计学意义(P<0.05).结论 PFNA内固定联合阿仑膦酸钠治疗老年股骨粗隆间骨折临床效果较好,并能提高骨密度,预防再骨折的发生.
目的 探討抗鏇轉股骨近耑髓內釘(PFNA)內固定聯閤阿崙膦痠鈉治療老年股骨粗隆間骨摺的效果.方法 選擇唐山市中醫醫院2010年1月至2014年1月收治的老年股骨粗隆間骨摺患者57例,根據隨機數字錶法分為觀察組(28例)與對照組(29例),2組均給予PFNA內固定治療,術後均給予碳痠鈣D3片600 mg,1次/d,口服.觀察組術後2週給予阿崙膦痠鈉70 mg口服,每週1次.2組療程均為1年.觀察2組患者手術相關併髮癥、骨摺愈閤時間、髖關節功能、抗骨質疏鬆治療結束後L2~4椎體骨密度水平以及再骨摺髮生情況.結果 2組患者均未髮生骨摺不愈閤或畸形愈閤,無螺釘鬆動和傷口感染,未見脂肪栓塞、深靜脈血栓等.觀察組與對照組患者骨摺愈閤時間、髖關節功能比較,差異無統計學意義(P>0.05),骨密度比較[(0.79 ±0.10)g/cm2比(0.64 ±0.04)g/cm2],差異有統計學意義(P<0.05).術後隨訪10~20箇月,觀察組患者未見其他部位再骨摺,對照組4例髮生其他部位再骨摺[0.0% (0/28)比13.8% (4/29)],2組比較差異有統計學意義(P<0.05).結論 PFNA內固定聯閤阿崙膦痠鈉治療老年股骨粗隆間骨摺臨床效果較好,併能提高骨密度,預防再骨摺的髮生.
목적 탐토항선전고골근단수내정(PFNA)내고정연합아륜련산납치료노년고골조륭간골절적효과.방법 선택당산시중의의원2010년1월지2014년1월수치적노년고골조륭간골절환자57례,근거수궤수자표법분위관찰조(28례)여대조조(29례),2조균급여PFNA내고정치료,술후균급여탄산개D3편600 mg,1차/d,구복.관찰조술후2주급여아륜련산납70 mg구복,매주1차.2조료정균위1년.관찰2조환자수술상관병발증、골절유합시간、관관절공능、항골질소송치료결속후L2~4추체골밀도수평이급재골절발생정황.결과 2조환자균미발생골절불유합혹기형유합,무라정송동화상구감염,미견지방전새、심정맥혈전등.관찰조여대조조환자골절유합시간、관관절공능비교,차이무통계학의의(P>0.05),골밀도비교[(0.79 ±0.10)g/cm2비(0.64 ±0.04)g/cm2],차이유통계학의의(P<0.05).술후수방10~20개월,관찰조환자미견기타부위재골절,대조조4례발생기타부위재골절[0.0% (0/28)비13.8% (4/29)],2조비교차이유통계학의의(P<0.05).결론 PFNA내고정연합아륜련산납치료노년고골조륭간골절림상효과교호,병능제고골밀도,예방재골절적발생.
Objective To investigate the clinical effect of proximal femoral nail anti-rotation PFNA) combined with alendronate in treating femoral intertrochanteric fracture in elderly patients.Methods Totally 57 elderly patients with femoral intertrochanteric fiacture from January 2010 to January 2014 were randomly divided into observation group (28 cases) and control group (29 cases).All patients were treated with PFNA and oral calcium D3 tablets (600 mg, once a day).Two weeks after surgery, the patients in observation group were treated with oral alendronate (70 mg, once a week).The treatment was lasted for one year.The postoperative complications, fracture healing time, function of hip joint and bone mineral density of L2-4 vertebral body after treatment were compared between groups.Results No nonunion or malunion, screw loosening and wound infection, fat embolism and deep vein thrombosis occurred in both groups.The fracture healing time and function of hip function were not statistically different (P > 0.05).The bone mineral density of L2-4 vertebral body in observation group was significantly higher than that in control group after treatment [(0.79 ± 0.10) g/cm2 vs (0.64 ± 0.04) g/cm2](P < 0.05).During 10-20 months of followed-up, the rate of refracture observation group was significantly lower than that in control group [0.0% (0/28) vs 13.8% (4/29)] (P <0.05).Conclusion PFNA combined with alendronate has good effect in treating femoral intertrochanteric fractures in elderly patients, and can increase the bone density and prevent recurrent fracture.