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[1]龔江浩.股骨近端防旋髓內釘聯(lián)合抗骨質疏松藥物治療 不穩(wěn)定型老年股骨轉子間骨折的臨床觀察[J].中醫(yī)正骨,2015,27(04):29-32.
　GONG Jianghao.A combination therapy of proximal femoral nail antirotation and anti-osteoporotic drugs for the treatment of unstable femoral intertrochanteric fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):29-32.
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股骨近端防旋髓內釘聯(lián)合抗骨質疏松藥物治療 不穩(wěn)定型老年股骨轉子間骨折的臨床觀察()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數:
2015年04期
頁碼:
29-32
欄目:
臨床研究
出版日期:
2015-04-30

文章信息/Info

Title:
A combination therapy of proximal femoral nail antirotation and anti-osteoporotic drugs for the treatment of unstable femoral intertrochanteric fractures in the aged
作者:
龔江浩
溫州醫(yī)科大學附屬義烏醫(yī)院,浙江 義烏 322000
Author(s):
GONG Jianghao
Yiwu Hospital Affiliated to Wenzhou Medical University,Yiwu 322000,Zhejiang,China
關鍵詞:
髖骨折;  轉子間骨折;  抗骨質疏松藥;  骨質疏松;  老年人;  股骨近端防旋髓內釘;  骨密度;  骨痂;  治療; 臨床研究性
Keywords:
hip fractures;  intertrochanteric fractures;  anti-osteoporotic;  osteoporosis;  aged;  proximal femoral nail antirotation;  bone density;  bony callus;  therapies; investigational
摘要:
目的:探討股骨近端防旋髓內釘(proximal femoral nail antirotation,PFNA)聯(lián)合抗骨質疏松藥物治療老年不穩(wěn)定型股骨轉子間骨折的臨床療效。方法:將納入研究的140例股骨轉子間骨折患者隨機分為聯(lián)合治療組和PFNA組。聯(lián)合治療組采用PFNA內固定術聯(lián)合口服阿法骨化醇軟膠囊、強骨膠囊及維生素D治療,PFNA組單純采用PFNA內固定治療。觀察住院時間、骨痂出現(xiàn)時間、骨折愈合時間及術后6個月時的Harris髖關節(jié)評分和骨密度。結果:2組患者住院時間及術后6個月Harris評分比較,組間差異均無統(tǒng)計學意義[(15.55±5.13)d,(16.04±5.44)d,t=0.805,P=0.611;(86.23±6.55)分,(85.14±6.06)分,t=1.006,P=0.239]; 與PFNA組相比,聯(lián)合治療組骨痂出現(xiàn)早,骨折愈合快,術后6個月時Ward三角、股骨頸及股骨大轉子的骨密度更高[(29.38±4.67)d,(37.55±5.32)d,t=6.126,P=0.009;(3.11±1.14)月,(3.56±1.27)月,t=5.007,P=0.013;(0.877±0.024)g·cm-2,(0.648±0.012)g·cm-2,t=9.552,P=0.001;(1.011±0.064)g·cm-2,(0.802±0.018)g·cm-2,t=11.227,P=0.000;(0.882±0.035)g·cm-2,(0.686±0.023)g·cm-2,t=8.217,P=0.002]。結論:在PFNA內固定的基礎上聯(lián)合應用抗骨質疏松藥物,可提高老年不穩(wěn)定型股骨轉子間骨折患者的骨密度,加快骨折愈合。
Abstract:
Objective:To observe the clinical curative effects of proximal femoral nail antirotation(PFNA)combined with anti-osteoporotic drugs in the treatment of unstable femoral intertrochanteric fractures in the aged.Methods:One hundred and forty patients with femoral intertrochanteric fractures enrolled in the study were randomly divided into combination treatment group and PFNA group.The patients in combination treatment group were treated with PFNA internal fixation combined with oral application of alfacalcidol soft capsules,Qianggu(強骨)capsules and Vitamin D(Vit D); while the others in PFNA group were treated with the monotherapy of PFNA internal fixation.The hospital stay,bony callus and fracture healing time were observed.Harris hip scores and bone density were evaluate at six months after surgery.Results:There was no statistical difference in hospital stay and Harris scores at six months after surgery between the two groups(15.55+/-5.13 vs 16.04+/-5.44 days,t=0.805,P=0.611; 86.23+/-6.55 vs 85.14+/-6.06 points,t=1.006,P=0.239).Compared with PFNA group,combination treatment group has shorter bony callus appearing time,shorter fracture healing time and higher bone density of Ward's triangle,femoral neck and greater trochanter of femur at six months after surgery(29.38+/-4.67 vs 37.55+/-5.32 days,t=6.126,P=0.009; 3.11+/-1.14 vs 3.56+/-1.27 months,t=5.007,P=0.013; 0.877+/-0.024 vs 0.648+/-0.012 g/cm(2),t=9.552,P=0.001; 1.011+/-0.064 vs 0.802+/-0.018 g/cm(2),t=11.227,P=0.000; 0.882+/-0.035 vs 0.686+/-0.023 g/cm(2),t=8.217,P=0.002).Conclusion:Combination of anti-osteoporosis drugs with PFNA internal fixation can improve the bone density of aged patients with unstable femoral intertrochanteric fractures and accelerate fracture healing.

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備注/Memo

備注/Memo:
2014-12-09收稿 2015-01-16修回
更新日期/Last Update: 2015-04-30