不同时间服用双磷酸盐类药物对股骨颈骨折术后短期功能恢复的影响

摘要

Objective To compare the effects of diphosphonate medication at 2 weeks after operation and 4 weeks after operation on short functional recovery in patients with femoral neck fracture. Methods A total of 124 patients with femoral neck fracture who underwent hip replacement surgery in our hospital from Match 2014 to Match 2015 were enrolled in the study. These patients were randomly divided into two groups,group A (n=62) and group B (n=62).The patients in group A were given alendronate sodium medication at 2 weeks after operation,however,the patients in group B were given alendronate sodium medication at 12 weeks after operation,with postoperative follow up for both groups. The serum levels of calcium and vitamin D at 2 weeks,3 months,12 months after operation were detected,moreover, patient's functional recovery was assessed by de Morton Mobility Index,Barthel Index,Euro quality of life visual analog scale(Euro VAS),visual analog scale (VAS),6-min walk test,and timed get-up-and go test at 2w,3m, and 12m after surgery.Results At 3-month and 12-month follow-up after operation,there were significant differences in de Morton Mobility Index,Barthel Index,Euro quality of life visual analog scale (Euro VAS), visual analog scale (VAS),6-min walk test, and timed get-up-and go test in both groups,as compared with those at 2w after surgery(P<0.05). However there were no significant differences in these indexes and serum levels of calcium and vitamin D at 2w,3m and 12m after operation between the two groups(P>0.05). Moreover there was no significant difference in incidence rate of adverse events between two groups(χ2=2.567,P>0.05).Conclusion There are no significant differences in short-term functional recovery and incidence rate of adverse events between the two medication groups(at 2 weeks after operation vs at 12 weeks after operation),therefor,the patients with femoral neck fracture can be treated by diphosphonate medication at 2 weeks after surgery.%目的 比较股骨颈骨折术后2周与12周服用双磷酸盐类药物对患者短期功能恢复的影响.方法 选取收治的老年股骨颈骨折行髋关节置换术患者124例,随机分为2组:一组于术后2周起服用阿伦磷酸钠(2周组, n=62),另一组于术后12周起服用阿伦磷酸钠(12周组,n=62).术后随访并于2周、3个月、12个月检测2组血清钙和25(OH)D,评估2组患者de Morton 活动指数、Barthel 指数、欧洲直观式健康量表(euro quality of life visual analog scale,EQ VAS)、视觉模拟评分法(visual analog scale,VAS)、6 min步行试验(6 minute walk test,6MWT)、"起立-行走"计时测试.结果 术后随访3、12个月,2组患者de Morton活动指数、Barthel指数、EQ VAS、VAS、6MWT、"起立-行走"计时测试与术后2周比较差异有统计学意义(P<0.05);2组间上述观察指标及血清钙、25(OH)D水平比较均无统计学意义(P>0.05).2组不良反应比较差异无统计学意义(χ2=2.567,P=0.109).结论 2周与12周起服用双磷酸盐类药物对股骨颈骨折患者术后短期功能无显著差异,股骨颈骨折患者可于术后2周开始服用双磷酸盐类药物.