唑来膦酸对骨质疏松性股骨粗隆间骨折的临床疗效观察

目的：观察应用唑来膦酸对老年骨质疏松性股骨粗隆间骨折临床疗效的影响。方法：将本院2012年1月-2014年1月采用闭合复位髓内钉固定术治疗的64例骨质疏松性粗隆间骨折患者按照随机数字表法分为治疗组34例和对照组30例。其中治疗组应用唑来膦酸进行治疗，对照组未应用唑来膦酸进行治疗。观察比较两组患者术前及术后1年的骨密度值、Harris髋关节功能评分、骨折愈合时间和再次骨折发生率。结果：治疗组的骨折愈合时间和Harris评分分别为（12.14±1.38）周、（89.42±4.82）分；对照组分别为（13.86±1.76）周、（88.54±4.54）分，两组比较差异均无统计学意义（P〉0.05）。术后1年治疗组骨密度平均为（0.728±0.134）g/cm2明显高于对照组的（0.542±0.138）g/cm2，且治疗组术后1年与术前骨密度比较差异有统计学意义（P〈0.05），对照组术后1年与术前骨密度比较差异无统计学意义（P〉0.05）。治疗组再次骨折发生率5.8%明显低于对照组的20.0%，比较差异有统计学意义（P〈0.05）。结论：老年骨质疏松性股骨粗隆间骨折内固定术后应用唑来膦酸能明显升高患者骨密度，预防患者再次骨折的发生，值得临床推广。

The Clinical Observation of Zoledronic Acid in Treatment of Osteoporotic Femoral Intertrochanteric Fracture

Objective：To observe the clinical effect of zoledronic acid in treatment of the senile osteoporotic femoral intertrochanteric fractures.Method：64 cases of osteoporotic femoral intertrochanteric fractures with closed reduction and intramedullary nail fixation from January 2012 to January 2014 were randomly divided into the treatment group for 34 cases and the control group for 30 cases.The treatment group was treated with zoledronic acid,the control group was not treated with zoledronic acid.The BMD,Harris hip function score,fracture healing time and refracture rate before and post operation 1 year later of the two groups were observed and compared.Result：The healing time of fracture and Harris score of patients in the treatment group were（12.14±1.38）weeks,（89.42±4.82）scores;which in the control group were（13.86±1.76）weeks,（88.54±4.54）scores,there were no significant differences in the two groups （P〉0.05）.The bone mineral density of the treatment group during 1 year of treatment later was（0.728±0.134）g/cm2,it was significantly higher than（0.542±0.138）g/cm2 in the control group.Those change were significant difference for the treatment group but no significant difference for the control group.The refracture occurrence rate of the treatment group was 5.8%,it was significantly lower than 20.0%of the control group. the difference was statistically significant（P〈0.05）. Conclusion：Zoledronic acid can significantly increase the bone density of patients which have senile osteoporotic intertrochanteric fracture after internal fixation,and it can prevent the occurrence of refracture open again,is worthy of clinical promotion.