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PFNA与AFHR治疗不稳定型股骨粗隆间骨折疗效对比
Comparative Study of Clinical Efficacy of PFNA and AFHR in the Treatment of Unstable Femoral Intertrochanteric Fracture

赵伟,吴玉成.PFNA与AFHR治疗不稳定型股骨粗隆间骨折疗效对比[J].中国烧伤创疡杂志,2022,(5):357~360.

DOI：

中文关键词: 股骨近端防旋髓内钉人工股骨头置换术不稳定型股骨粗隆间骨折髋关节功能

英文关键词:Proximal femoral nail antirotation Artificial femoral head replacement Unstable femoral intertrochanteric fracture Hip joint function

基金项目:

作者	单位
赵伟	464300 河南信阳, 息县人民医院骨科
吴玉成

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中文摘要:

【摘要】目的对比分析股骨近端防旋髓内钉(PFNA)内固定术与人工股骨头置换术(AFHR) 治疗不稳定型股骨粗隆间骨折的临床效果。方法选取2016年1月至 2019年3月息县人民医院收治的74例不稳定型股骨粗隆间骨折患者作为研究对象，根据不同治疗方法将其分为 PFNA组(37例)与AFHR组(37例)，PFNA组患者采用PFNA内固定术治疗，AFHR组患者采用 AFHR治疗，对比观察两组患者手术相关情况、髋关节功能以及并发症发生情况。结果 PFNA 组患者手术时间明显短于AFHR组，术中出血量、术后引流量均明显少于AFHR组，手术至下床活动时间明显长于AFHR组(t=15.766、12.679、22.652、13.291，P均＜0.001);术后6、12个月， PFNA组患者Harris评分均明显高于AFHR 组( t = 4.798、4.303，P均＜0.001);其间, PFNA组患者并发症发生率为 13.51%，AFHR组患者并发症发生率为 5.41%，两组间无明显差异(χ2= 1.420,P = 0.033)。结论与AFHR 治疗不稳定型股骨粗隆间骨折相比,PFNA内固定术后虽下床活动时间较晚,但可明显缩短手术时间,提高髋关节功能恢复效果,远期疗效更好,值得临床推广应用。

英文摘要:

【Abstract】 Objective To compare and analyze the clinical efficacy of proximal femoral nail antirotation (PFNA) and artificial femoral head replacement (AFHR) in the treatment of unstable femoral intertrochanteric fractures. Methods 74 patients with unstable femoral intertrochanteric fractures, admitted to Xixian People’s Hospital from January 2016 to March 2019, were enrolled as subjects, and divided into PFNA group (n=37) receiving PFNA, and AFHR group (n=37) receiving AFHR. The surgery-related indexes, hip joint functions and occurrence of complications of patients were compared between the two groups. Results Compared with AFHR group, the operation time of patients in PFNA group was much shorter (t=15.766,P＜0.001),and intraoperative blood loss and postoperative drainage volume were much smaller(t = 12.679,22.652,both P＜0.001),but the time from operation to first-time ambulation was significantly longer （t= 13.291,P＜0.001).Respectively at 6 and 12 months after surgery, Harris scores of patients were much higher in PFNAgroup than AFHR group (t = 4.798 and 4.303,both P <0.001).During the course of treatment, the incidence of complications in PFNA group was 13.51%,which showed no significant difference compared with 5.41% in AFHR group（χ2=1.420,P=0.233).Conclusion In the treatment of unstable femoral intertrochanteric fracture, PFNA can significantly shorten operation time, restore hip joint functions well, and realize better longterm therapeutic effect compared with AFHR, though it needs more time for first-time ambulation.