鲑鱼降钙素对老年患者人工肱骨头置换术后影响的疗效观察

目的:观察抗骨质疏松药物对老年肱骨近端骨折患者行人工股骨头置换后的疗效影响。方法 :2012年11月至2016年6月肱骨近端骨折行人工肱骨头置换术患者38例,依据术后是否应用抗骨质疏松药物分为治疗组和对照组,治疗组19例,其中3部分骨折11例、4部分骨折8例,骨密度(0.58±0.14) g/cm~2;对照组19例,其中3部分骨折10例、4部分骨折9例,骨密度(0.58±0.11) g/cm~2。检测两组术前、术后4、8、12、24、48周假体周围骨密度(BMD),并行VAS疼痛评分,采用Neer评分系统评价肩关节功能。结果:术后患者切口均为甲级愈合,无并发症发生。35例患者获得1年随访。治疗组假体周围骨密度高于对照组,差异有统计学意义(P0.05);两组患者术后2、8周VAS评分差异无统计学意义(P0.05);治疗组Neer评分总分及功能评分优于对照组,差异有统计学意义(P0.05),疼痛及活动度评分两组比较,差异无统计学意义(P0.05)。依据Neer评分系统,治疗组优10例,良5例,可3例;对照组优3例,良9例,可5例;两组比较差异有统计学意义(P0.05)。结论:人工肱骨头置换结合抗骨质疏松药物治疗老年肱骨近端骨折可有效提高假体周围骨密度,恢复肩关节功能,早期临床效果满意。

Effect of salmon calcitonin on postoperative humeral head replacement in elderly patients

Objective: To observe the effect of anti-osteoporosis drugs on the curative effect of femoral head replacement in the elderly patients with proximal humerus fracture.Methods: From November 2012 to June 2016, 38 patients with proximal humeral fractures received humeral head replacement were divided into the treatment group and the control group according to whether the anti-osteoporosis drugs were used after the operation. The treatment group included 19 cases, of which 11 cases were three part fractures, 18 cases were four part fractures, and bone density was (0.58±0.14)g/cm²;the control group involved 19 cases, of which 10 cases were the three part fractures, 9 cases were four part fractures, and bone density was (0.58±0.11) g/cm². Periprosthetic bone mineral density (BMD) was measured at 4, 8, 12, 24 and 48 weeks after operation, and visual analogue scale (VAS) was used to evaluate the pain and Neer score was used to evaluate the function of the shoulder joint.Results: The incisions of all patients were healed with grade A and no complications occurred. Thirty-five patients were followed up for 1 year. The bone density around the prosthesis of treatment group was higher than that of control group, the difference was statistically significant (P<0.05);VAS in two groups had no statistical significance (P>0.05). The total score and functional score of Neer in the treatment group were better than those in the control group, the difference was statistically significant (P<0.05), and there was no significant difference in pain and activity score between the two groups (P>0.05). According to the Neer score, the results of treatment group was excellent in 10 cases, good in 5 cases, fair in 3 cases;in the control group, 3 cases were excellent, 9 cases were good, and 5 cases were fair;the difference between the two groups was statistically significant (P<0.05).Conclusion: Artificial humeral head replacement combined with anti-osteoporosis drugs in the treatment of proximal humeral fractures in elderly patients can effectively improve the bone density around the prosthesis and restore shoulder function. The early clinical effect is satisfactory.