LISS 钢板倒置与亚洲型股骨近端防旋髓内钉治疗老年不稳定型股骨粗隆间骨折的疗效分析

摘要

Objective To compare the clinical curative effect of LISS steel plate inversion with Asian femoral proximal screw nails PFNA treatment of elderly unstable intertrochanteric fractures. Methods Elderly unstable type of 80 patients with intertrochanteric fracture were includ-ed into the present study. A random number table method was used to divide the patient into the LISS and PFNA group. The LISS group of 40 pa-tients were treated with LISS steel plate inversion,PFNA group 40 patients accepted Asian proximal femur preventing rotation intramedullary nail-ing PFNA treatment. The operation time,incision length,intraoperative blood loss,postoperative flow,fracture healing time,clinical curative effect and complications were compared. Results The length,operating time,intraoperative blood loss,led traffic,healing time of the PFNA group were significantly less than those of the LISS group. The hip score of PFNA group was significantly higher than that of LISS group. The post-operative hemoglobin levels of PFNA group was significantly higher than that of LISS group. And postoperative blood sedimentation level,limb swelling degree,limb swelling time were significantly lower than the control group. The total effective rate of PFNA group 95. 0% ,which was sig-nificantly higher than that of LISS group was 75. 0% . The complication rate of LISS group was 30. 0% . The PFNA group was significantly higher than 5. 0% ,the difference had statistical significance( P ﹤ 0. 05). Conclusion The treatment of elderly unstable intertrochanteric fractures,A-sian proximal femur preventing rotation intramedullary nailing PFNA was significantly better than the LISS steel plate upside down. This method is the most curative effect and safety of treatment plan,is worth of clinical extensive application and promotion.%目的：比较微创内固定系统（LISS）钢板倒置与亚洲型股骨近端防旋髓内钉（PFNA）治疗老年不稳定型股骨粗隆间骨折的临床疗效。方法老年不稳定型股骨粗隆间骨折患者80例，随机数字表法分为 LISS 组与 PFNA 组，其中 LISS 组40例患者接受 LISS 钢板倒置治疗，PFNA 组40例患者接受 PFNA 治疗，比较两组手术时间、手术切口长度、术中出血量、术后引流量及骨折愈合时间。比较两组患者临床疗效及并发症。结果 PFNA 组的术口长度、手术时间、术中出血量、引流量、愈合时间均显著少于 LISS 组；PFNA 组髋关节评分显著高于 LISS 组；PFNA 组术后血红蛋白水平显著高于 LISS 组，而术后红细胞沉降率水平、患肢肿胀程度、患肢消肿时间均显著低于对照组；PFNA 组总有效率95.0%，显著高于 LISS 组的75.0%；LISS 组并发症发生率30.0%，显著高于 PFNA 组的5.0%，差异均有统计学意义（ P ﹤0.05）。结论治疗老年不稳定型股骨粗隆间骨折，亚洲型 PFNA 显著优于 LISS 钢板倒置，是最有效最安全的治疗方案，值得临床推广应用。