PFNA与BFNR治疗老年股骨粗隆间骨折的临床疗效

目的 比较股骨近端防旋髓内钉（PFNA）与人工双极股骨头置换术（BFNR）治疗老年股骨粗隆间骨折的疗效差异。方法 选取2016年6月~2018年6月在我院治疗的58例老年股骨粗隆间骨折患者，按随机数表法分成对照组与观察组，各29例，对照组行PFNA，观察组行BFNR，比较两组手术相关指标与术后髋关节功能量表（Harris）评分。结果 观察组手术时间（73.56±11.44）min、切口长度（13.84±3.13）cm、失血量（345.18±32.58）ml均高于对照组的（65.24±11.15）min、（9.24±2.35）cm、（233.04±20.63）ml，卧床时间（7.49±1.83）d短于对照组（15.74±2.32）d，差异均有统计学意义（P＜0.05）；观察组术后1周及1个月Harris评分高于对照组，差异有统计学意义（P＜0.05）。结论 相比PFNA术，BFNR术治疗老年股骨粗隆间骨折，可有效缩短患者卧床时间，促进术后髋关节功能恢复。

Therapeutic Effect of Proximal Femoral Nail and Artificial Bipolar Femoral Head Replacement for the Treatment of Intertrochanteric Fractures in the Elderly

Abstract:Objective To compare the efficacy of proximal femoral nail fixation (PFNA) and artificial bipolar femoral head replacement (BFNR) in the treatment of intertrochanteric fractures in the elderly.Methods A total of 58 elderly patients with intertrochanteric fractures who were treated in our hospital from June 2016 to June 2018 were randomly divided into the control group and the observation group, 29 cases in each group. The control group received PFNA. Research group received BFNR, comparing the surgical outcomes of the two groups with the postoperative hip function scale (Harris) score.Results In the observation group, the operation time (73.56±11.44) min, the length of the incision (13.84±3.13) cm, and the blood loss (345.18±32.58) ml were higher than those of the control group (65.24±11.15) min, (9.24±2.35) cm, (233.04±20.63) ml, bed time (7.49±1.83) d was shorter than the control group (15.74±2.32) d, the difference was statistically significant (P<0.05); the observation group had high Harris score 1 week and 1 month after operation. In the control group, the difference was statistically significant (P<0.05).Conclusion Compared with PFNA, BFNR is an effective treatment for elderly patients with intertrochanteric fractures, which can effectively shorten bed rest time and promote postoperative hip function.