髓内固定与髓外固定治疗老年股骨粗隆间骨折的效果及其对隐性失血的影响
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摘要
目的探讨髓内固定与髓外固定治疗老年稳定型股骨粗隆间骨折的效果及其对隐性失血的影响。方法将我院收治的86例稳定型股骨粗隆间骨折老年患者随机分为对照组(髓内固定治疗)和研究组(髓外固定治疗),各43例。比较两组的治疗效果。结果术后,两组Zuckerman FRC评分均升高(P<0.05),但组间的Zuckerman FRC评分、骨折愈合时间比较无显著差异(P>0.05)。研究组总失血量、隐性失血量少于对照组,输血率低于对照组(P<0.05)。研究组肺炎、电解质失衡及低蛋白血症发生率均低于对照组(P<0.05)。结论髓内与髓外固定治疗老年稳定型股骨粗隆间骨折效果均显著,但髓外固定失血量及术后并发症少,临床应用价值更高。
Objective To investigate the effect of intramedullary and extramedullary fixation on senile stable intertrochanteric femoral fractures and the impact on hidden hemorrhage. Methods Eighty-six elderly patients with stable intertrochanteric femoral fractures admitted in our hospital were randomly divided into control group(intramedullary fixation)and study group(extramedullary fixation), with 43 cases in each group. The therapeutic effects were compared between the two groups. Results After operation, the Zuckerman FRC scores of both groups increased(P <0.05), but there were no significant differences in the Zuckerman FRC scores and fracture healing time between the two groups(P>0.05). The volume of total blood loss and hidden hemorrhage in the study group were less than those in the control group, and the transfusion rate was lower than that in the control group(P<0.05). The incidences of pneumonia, electrolyte imbalance and hypoproteinemia in the study group were lower than those in the control group(P <0.05). Conclusion The effects of intramedullary and extramedullary fixation on senile stable intertrochanteric femoral fracture are remarkable, but extramedullary fixation has less blood loss and complications, with higher clinical application value.
Objective To investigate the effect of intramedullary and extramedullary fixation on senile stable intertrochanteric femoral fractures and the impact on hidden hemorrhage. Methods Eighty-six elderly patients with stable intertrochanteric femoral fractures admitted in our hospital were randomly divided into control group(intramedullary fixation)and study group(extramedullary fixation), with 43 cases in each group. The therapeutic effects were compared between the two groups. Results After operation, the Zuckerman FRC scores of both groups increased(P <0.05), but there were no significant differences in the Zuckerman FRC scores and fracture healing time between the two groups(P>0.05). The volume of total blood loss and hidden hemorrhage in the study group were less than those in the control group, and the transfusion rate was lower than that in the control group(P<0.05). The incidences of pneumonia, electrolyte imbalance and hypoproteinemia in the study group were lower than those in the control group(P <0.05). Conclusion The effects of intramedullary and extramedullary fixation on senile stable intertrochanteric femoral fracture are remarkable, but extramedullary fixation has less blood loss and complications, with higher clinical application value.
引文
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[6]黄国平,徐永金,王俊新,等.LCP、DHS、PFNA治疗不稳定型股骨粗隆间骨折疗效的比较[J].医学综述,2014,20(22):4220-4222.
[2]朱书涛,刘洋,张明辉,等.股骨粗隆间骨折DHS内固定术后骨折不愈合的危险因素[J].中国矫形外科杂志,2016,24(12):1076-1079.
[3]SHEN L,ZHANG Y,SHEN Y,et al.Antirotation proximal femoral nail versus dynamic hip screw for intertrochanteric fractures:a metaanalysis of randomized controlled studies[J].Orthop Traumatol Surg Res,2013,99(4):377-383.
[4]ZUCKERMAN JD,KOVAL KJ,AHARONOFF GB,et al.A functional recovery score for elderly hip fracture patients:II.Validity and reliability[J].J Orthop Trauma,2000,14(1):20-25.
[5]NADLER SB,HIDALGO JH,BLOCH T.Prediction of blood volume in normal human adults[J].Surgery,1962,51(2):224-232.
[6]黄国平,徐永金,王俊新,等.LCP、DHS、PFNA治疗不稳定型股骨粗隆间骨折疗效的比较[J].医学综述,2014,20(22):4220-4222.