CAJ | 학술논문

目的：观察唑来膦酸在老年不稳定型股骨粗隆间骨折解剖锁定钢板内固定术后的应用效果。方法：符合条件的患者共67例，随机分为2组，A组术后第5天静脉注射唑来膦酸5 mg，B组未接受唑来膦酸治疗。统计分析两组患者住院时间、并发症、患肢负重时间、骨折愈合时间、术后髋关节功能评分、术前术后血清钙、血清碱性磷酸酶（ALP）浓度、术后1年及术前股骨近端骨密度，评价疗效。结果：两组患者在年龄、骨折类型构成、住院时间、部分负重时间、骨折愈合时间、术后1个月及1年时髋关节功能、术前平均骨密度及术前术后血钙变化方面比较差异无显著性；两组术后3个月和6个月时髋关节功能、术后1年平均骨密度及术后1年血清ALP比较差异有显著性。并发症方面，A组有5例患者出现肌痛或发热。结论：唑来膦酸在老年不稳定型股骨粗隆间骨折锁定钢板内固定术后使用，能抑制骨量丢失，增加骨密度，加快术后肢体功能恢复，其主要存在的问题是药物不良反应发生率较高。
목적：관찰서래련산재노년불은정형고골조륭간골절해부쇄정강판내고정술후적응용효과。방법：부합조건적환자공67례，수궤분위2조，A조술후제5천정맥주사서래련산5 mg，B조미접수서래련산치료。통계분석량조환자주원시간、병발증、환지부중시간、골절유합시간、술후관관절공능평분、술전술후혈청개、혈청감성린산매（ALP）농도、술후1년급술전고골근단골밀도，평개료효。결과：량조환자재년령、골절류형구성、주원시간、부분부중시간、골절유합시간、술후1개월급1년시관관절공능、술전평균골밀도급술전술후혈개변화방면비교차이무현저성；량조술후3개월화6개월시관관절공능、술후1년평균골밀도급술후1년혈청ALP비교차이유현저성。병발증방면，A조유5례환자출현기통혹발열。결론：서래련산재노년불은정형고골조륭간골절쇄정강판내고정술후사용，능억제골량주실，증가골밀도，가쾌술후지체공능회복，기주요존재적문제시약물불량반응발생솔교고。
Objective To investigate the efficacy of zoledronic acid in the treatment of senile unstable femoral intertrochanteric fractures with anatomical locking plate. Methods 67 patients were randomly divided into two groups. Five days after the operation, group A received one intravenous injection of 5 mg zoledronic acid, while patients in group B did not receive the injection. The two groups were compared in terms of hospitalization time, complications, limb weight-bearing time, fracture healing time, hip function score after operation, preoperative and postoperative serum calcium and serum ALP, bone mineral density of proximal femur before operation and 1 year after operation. Results There were no statistically significant differences between the two groups in age, type of fracture, hospital stay, partial weight-bearing time, fracture healing time, hip function at 1 month and 1 year after operation, preoperative bone mineral density and blood calcium. But the differences were statistically different in hip function at 3 months after operation , averaged bone mineral density of proximal femur and serum ALP 1 year after operation. Moreover, 5 patients in group A developed muscle pain or fever after intravenous injection of zoledronic acid. Conclusion The locking plate combined with zoledronic acid injection in treatment of elderly patients with unstable femoral intertrochanteric fracture could inhibit bone loss, increase bone mineral density, and accelerate limb function recovery after operation. On the other hand, Zoledronic acid has a high incidence of adverse reaction.