宋德臣 苏向伟 邢斌 李瑞

【摘要】 目的：探討股骨近端防旋髓内钉与骨水泥半髋置换在老年股骨粗隆间骨折患者中的应用。方法：选取笔者所在医院2017年5月-2019年5月收治的老年股骨粗隆间骨折患者86例，按照随机数字表法将其分为两组，各43例。对照组应用股骨近端防旋髓内钉治疗，研究组应用骨水泥半髋置换治疗。比较两组手术情况、髋关节功能恢复情况及并发症发生率。结果：研究组手术时间长于对照组，出血量多于对照组，差异均有统计学意义（P<0.05）。研究组住院时间、术后负重时间及并发症发生率均优于对照组，差异有统计学意义（P<0.05）。研究组治疗后Harris评分高于对照组，差异有统计学意义（P<0.05）。结论：采用股骨近端防旋髓内钉治疗可以缩短患者手术时间，减少出血量。采用骨水泥半髋置换治疗可以缩短患者住院时间及术后负重时间，降低并发症发生率，促进患者髋关节功能恢复，提高整体治疗效果。

【关键词】 股骨近端防旋髓内钉 骨水泥半髋置换 老年股骨粗隆间骨折 手术情况 术后恢复

doi：10.14033/j.cnki.cfmr.2020.13.010 文献标识码 B 文章编号 1674-6805（2020）13-00-03

A Randomized Controlled Study of Proximal Femoral Anti-rotation Intramedullary Nail and Bone Cement Hemiarthroplasty in Elderly Patients with Intertrochanteric Fractures/SONG Dechen， SU Xiangwei， XING Bin， LI Rui. //Chinese and Foreign Medical Research， 2020， 18（13）： -28

[Abstract] Objective： To investigate the application of proximal femoral anti-rotation intramedullary nail and bone cement hemiarthroplasty in elderly patients with intertrochanteric fractures. Method： A total of 86 elderly patients with intertrochanteric fractures admitted in our hospital from May 2017 to May 2019 were selected and divided into two groups according to the random number table method， with 43 patients in each group. The control group was treated with proximal femoral anti-rotation intramedullary nail， and the study group was treated with bone cement hemiarthroplasty. The operation situation， hip joint function recovery situation and complication rate of the two groups were compared. Result： The operation time of the study group was longer than that of the control group， and the amount of blood loss was more than that of the control group， the differences were statistically significant （P<0.05）. The hospitalization time， postoperative weight-bearing time and complication rate of the study group were all better than those of the control group， the differences were statistically significant （P<0.05）. After treatment， the Harris score in the study group was higher than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion： The treatment of proximal femoral anti-rotation intramedullary nail can shorten the operation time and reduce the amount of blood loss，and the treatment of bone cement hemiarthroplasty can shorten the hospitalization time and postoperative weight-bearing time， reduce complications rate，promote the recovery of hip joint function， and improve the overall treatment effect.

[Key words] Proximal femoral anti-rotation intramedullary nail Bone cement hemiarthroplasty Intertrochanteric fractures in the elderly Operation situation Postoperative recovery

First-authors address： Beijing Del Connie Orthopaedic Hospital， Beijing 100143， China

骨折近端粉碎性骨折是老年股骨粗隆间骨折特点，以往多采用钉板系统对骨折部位进行固定，但是随临床应用发现，其失败率较高，患者术后髋关节功能恢复情况不佳[1]。随着医疗技术的不断革新，固定器械及手术方案均得到明显提高，使得股骨粗隆间骨折手术的手术时间及出血量明显降低，促进了患者髋关节功能的恢复[2]。此次研究通过对股骨近端防旋髓内钉及骨水泥半髋置换治疗的治疗方案进行分析，探究其临床疗效，分析不同手术方案对患者预后的影响，现报道如下。

1 资料与方法

1.1 一般资料

选取笔者所在医院2017年5月-2019年5月收治的老年股骨粗隆间骨折患者86例，按照随机数字表法将其分为两组，各43例。对照组男23例，女20例;年龄65～83岁，平均（78.4±2.3）岁;体质量43.4～74.3 kg，平均（57.3±2.1）kg。研究组男24例，女19例;年龄63～86岁，平均（78.5±2.1）岁;体质量42.6～73.5 kg，平均（57.5±2.3）kg。……