防旋型股骨近端髓內釘與動力髖螺釘治療股骨粗隆間骨折的療效對比

[摘要] 目的 探討股骨粗隆間骨折應用動力髖螺釘（DHS）和防旋型股骨近端髓內釘（PFNA）的治療效果。方法 以隨機紅藍簽抽簽的方式，隨機將方便選取的2013年7月—2016年7月期間于該院進行治療的股骨粗隆間骨折患者80例分為DHS組（n=40例）和PFNA組（n=40例），前者使用DHS治療方案，而后者使用PFNA治療方案，通過對比研究的方式，探討PFNA與DHS的臨床應用價值。結果 PFNA組平均引流量（42.52±18.32）mL、手術時間（42.16±10.18）min、術中出血量（82.13±20.46）mL、切口長度（8.25±0.67）cm均低于DHS組（P<0.05）；PFNA組、DHS組穩定型治療優良率分別為91.67%、92.86%，組間對比差異無統計學意義（P>0.05），PFNA組治療不穩定型患者的優良率96.43%顯著高于DHS組80.77%，差異有統計學意義（P<0.05）；PFNA組并發癥發生率10.00%顯著低于DHS組22.50%（P<0.05），差異有統計學意義。結論 臨床上將DHS、PFNA兩種治療方案應用于穩定型股骨粗隆間骨折患者，療效相當，而對于不穩定患者而言，可優先選擇PFNA治療方案。

[關鍵詞] 股骨粗隆間骨折；動力髖螺釘；防旋型股骨近端髓內釘；療效

[中圖分類號] R687 [文獻標識碼] A [文章編號] 1674-0742（2016）12（b）-0076-03

Comparison of Clinical Effect of Proximal Femoral Nail Anti-rotation and the Dynamic Hip Screw in Treatment of Intertrochanteric Fracture of Femur

MA Hai-tang ，JIA Shao-long

Yili Kazak Autonomous Prefecture of Kuitun Hospital of Department of Orthopedics，Yili， Xinjiang，833200 China

[Abstract] Objective To probe into the treatment effects of dynamic hip screw（DHS） and the proximal femoral nail anti-rotation（PFNA） in treatment of intertrochanteric fracture of femur. Methods We convenient selection 80 cases of intertrochanteric fracture of femur and who were treated in our hospital from July 2013 to July 2016 were randomly divided into DHS group （n=40 cases） and PFNA group（n=40 cases） by the random red and blue label draw methods.In the former were used the DHS treatment plan，while in the latter were used the PFNA treatment.Then，the clinical value of PFNA and DHS were discussed by the means of comparative study.Results The average blood flow（42.52±18.32）mL， operation time（42.16±10.18）min，blood loss during operation（82.13±20.46）mL， incision length （8.25±0.67）cm in th PFNA group were lower than those of DHS group （P<0.05）The excellent rates in the PFNA group and DHS group respectively were 91.67% and 92.86% ， and there was no significant difference between groups （P>0.05），TheThe excellent and good rate of treatment in patients with unstable type in the PFNA group was 96.43%，which was significantly higher than that in DHS group of 80.77%，the difference was statistically significant（P<0.05），The incidence of complications in group PFNA was 10%，which was significantly lower than that in DHS group of 22.50%，the difference was statistically significant（P<0.05）. Conclusion The clinical application of two treatment schemes for PFNA and DHS in patients with stable intertrochanteric fracture，which the clinical effect is considerable， and for patients with unstable， it can be a priority to choose PFNA treatment program.

[Key words] Intertrochanteric fracture of femur；Dynamic hip screw； Anti rotation proximal femoral nail； Clinical effect

股骨是人體重要承重骨骼，而股骨粗隆間骨折骨科常見疾病類型，且隨著我國社會老齡化程度的加重，發病例數逐年增多，再加上骨質疏松是大部分老年人的常見病，因而，臨床上不穩定型股骨粗隆間骨折的發病率較高，由此手術成為主要治療手段，但是，何種內固定器械的治療效果最佳，一直是臨床研究的熱點，因此，該文收集該院2013年7月—2016年7月期間收治的80例股骨粗隆間骨折患者作對比研究，探討DHS、PFNA的臨床應用價值，現報道如下。

1 資料與方法

1.1 一般資料

以隨機紅藍簽……