目的：探讨股骨近端解剖锁定钢板(PFLP)与股骨近端防旋髓内钉(PFNA)治疗股骨转子间骨折的有效性和安全性。方法选择2012年1月至2014年1月辽阳市中心医院收治的120例股骨转子间骨折患者作为研究对象,根据随机数字法分为观察组(n =60)和对照组(n =60)。对照组给予 PFLP 治疗,观察组给予 PFNA 治疗。记录并比较两组患者的手术指标及术后情况、关节功能恢复情况、术后不同时间内 Harris 评分、术后并发症发生率。结果观察组手术时间、术中出血量、引流量、下地负重时间均少于或短于对照组(P <0．05)；骨折愈合时间两组比较差异无统计学意义(P >0．05)。治疗后12个月,观察组优良率为95．0%(57/60),对照组优良率为90．0%(54/60),两组患者关节功能恢复情况比较差异无统计学意义(P >0．05)。治疗后3、6、12个月观察组的 Harris 评分均高于对照组[(84．18±3．82)分比(77．09±5．23)分,(91．45±2．29)分比(86．38±2．84)分,(94．97±2．71)分比(94．23±3．49)分],组间、不同时点间、组间·不同时点间的交互作用比较差异有统计学意义(P <0．05)。观察组并发症发生率为5．00%(3/60),对照组为16．67%(10/60),观察组的并发症发生率低于对照组(P <0．05)。结论 PFLP 与 PFNA 均是治疗股骨转子间骨折的有效术式,但 PFNA 近期疗效优于 PFLP,且减少了术后并发症的发生,值得在临床推广应用。%Objective To investigate the effectiveness and safety of proximal femoral locking plate(PFLP) and proxi-mal femoral nail antirotation(PFNA) in the treatment of femoral intertrochanteric fractures. Methods From Jan. 2012 to Jan. 2014,120 cases of femoral intertrochanteric fractures in Liaoyang Central Hospital were included in the study,according to the random number method,they were divided into an observation group(n = 60) and a control group(n = 60). The con-trol group was treated with PFLP,while the observation group was treated with PFNA. The surgical treatment and postopera-tive conditions,the recovery of joint function,postoperative Harris score at different time points,incidence of postoperative complications of the two groups were recorded and compared. Results The operation time,intraoperative bleeding volume, drainage volume and the weight bearing time of the observation group were lower than the control group(P < 0. 05);fracture healing time was lower than the control group,the difference was not statistically significant(P < 0. 05). At 12 months after treatment,the excellent rate of the observation group was 95. 0% (57 / 60),of the control group was 90. 0% (54 / 60),there was no significant difference in the recovery effect of joint function between the two groups(P > 0. 05). At 3,6,12months after treatment,the Harris score of the observation group were higher than the control group[(84. 18 ± 3. 82) scores vs (77. 09 ± 5. 23) scores,(91. 45 ± 2. 29) scores vs (86. 38 ± 2. 84) scores,(94. 97 ± 2. 71) scores vs (94. 23 ± 3. 49) scores],the differences between groups,different time points,the interaction of the two groups · different time points were statistically significant(P < 0. 05). The complication incidence of the observation group was 5. 00% (3 / 60),of the control group was 16. 67% (10 / 60),the difference was statistically significant( P < 0. 05). Conclusion PFLP and PFNA are effective methods for treatment of femoral intertrochanteric fractures,but the short-term effect of PFNA is better than PFLP, and it can reduce the occurrence of postoperative complications,thus is worthy of clinical application.
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