闭合复位髓内钉内固定对高龄股骨粗隆间骨折术后疼痛患肢功能及生活质量的影响

目的 探究闭合复位髓内钉内固定术在高龄股骨粗隆间骨折治疗中对疼痛、患肢功能及生活质量的影响。方法 选取2015年12月至2016年12月156例股骨粗隆间骨折患者,78例行闭合复位髓内钉内固定术(实验组),78例行传统的切开复位髓外固定术(对照组),对纳入研究的所有患者临床资料进行回顾性分析。对2组患者术中手术时间、术中出血量、骨折愈合时间、术后并发症发生率、疼痛程度和日常生活活动情况、髋关节功能以及生活质量情况进行比较分析。结果 实验组患者术中手术时间、术中出血量、术后愈合时间、住院时间以及并发症的发生率均显著低于对照组(P<0.05)。实验组患者在术后72 h内的疼痛程度显著低于对照组(P<0.05)。实验组患者的日常生活能力、髋关节功能和生活质量水平均高于对照组(P<0.05),但在“社会”这个维度2组差异无统计学意义(P>0.05)。结论 闭合复位髓内钉内固定术治疗老年股骨粗隆间骨折有显著的临床治疗效果,具有并发症少、操作简单、创伤小、疼痛度低,显著提高患者的生活质量,值得临床推广应用。

Effect of closed reduction and intramedullary nailing on postoperative pain,limb function and quality of life in elderly patients with intertrochanteric fracture

Objective To investigate the effect of closed reduction and intramedullary nailing on the postoperative pain, limb function and quality of life in elderly patients with intertrochanteric fracture. Methods A total of 156 elderly patients with intertrochanteric fracture were selected from December 2015 to December 2016, and 78 cases were treated with closed reduction and intramedullary nail fixation (an experimental group) and 78 patients were treated with the conventional open reduction and intramedullary fixation. The clinical data of all the patients were retrospectively analyzed, including the operation time, intraoperative bleeding volume, fracture healing time, postoperative complications, degree of pain, activity of daily life, hip joint function, and life quality. Results The operation time, bleeding volume, postoperative healing time, hospitalization time and complication rate in the experimental group were significantly lower than those in the control group (P<0.05). The pain degree of the patients in the experimental group was significantly lower than that that in the control group (P<0.05) within 72 hours after the operation. The daily living ability, hip function and quality of life in the experimental group were superior to those in the control group (P<0.05). However, there was no significant difference between the two groups in the “society” dimensionality (P>0.05). Conclusion The closed reduction and intramedullary nail fixation in the treatment of senile intertrochanteric fracture has a significant therapeutic effect, with fewer complications, simple operation, small trauma, low pain degree, and higher quality of life of the patients.