PFNA治疗老性股骨粗隆间骨折重点.doc

山东中医药大学2012界硕士学位论文 PFNA微创治疗股骨粗隆间骨折的临床疗效观察  PAGE 36  PAGE 35 提 要 目的：通过观察比较动力髋螺钉（DHS）及股骨近端防旋髓内钉（PFNA）治疗股骨粗隆间骨折的临床实际效果，突出目前PFNA对股骨粗隆间骨折尤其是不稳定性股骨粗隆间骨折的治疗优势，并为以后的治疗提出建设性的意见。 方法：自山东中医药大学附属医院选入对比性分析病例共 46 例。其中切开复位 DHS 内固定 22 例，闭合复位 PFNA 内固定 24例。记录并比较两组患者手术时间、切口长度、术中出血量、术后引流量、术后下地活动时间、术后髋关节功能恢复程度、术后并发症的发生率等，并对数据进行统计学处理，然后进行对比分析，得出结论。 结果：两组患者经过6-14个月的临床随访，并将记录的数据经过统计学处理，得出与DHS组相比，PFNA组手术时间短、术中出血量少，术后下地时间短、骨折愈合时间短、术后并发症少。而术后髋关节功能的恢复程度两者无显著差异。 结论：PFNA 在治疗股骨粗隆间骨折尤其是不稳定性股骨粗隆间骨折方面具有微创化、固定合理、可以早期下地、并发症少等优点，值得临床大力推广。 关键词 DHS；PFNA；对比性分析；股骨粗隆间骨折 Clinical efficacy of PFNA minimally invasive treatment of intertrochanteric fractures Speciality :OrthoPaedics of TCM Author:sunfengkun Tutor:Prof.WangMingxi Abstract Objective:Clinical practice the treatment of intertrochanteric fracture through the observation of the comparative dynamic hip screw (DHS) and proximal femur anti-spin intramedullary nail (PFNA), highlighting the current PFNA intertrochanteric fracture intertrochanteric instability the advantage of fracture treatment , and subsequent treatment for their constructive comments . Methods: a total of 46 cases selected from the Affiliated Hospital of Shandong University of Traditional Chinese Medicine into the comparative analysis of the cases . Which cut reset DHS internal fixation in 22 cases, closed reset PFNA fixed 24 cases . Record and compare the two groups were operative time, incision length , blood loss , postoperative drainage , postoperative ambulation time , degree of recovery of hip function after surgery , the incidence of postoperative complications , and statistical data chemical treatment , and then were analyzed and concluded . Results: The patients after 6-14 months of clinical follow-up and record the data after statistical processing obtained compared with the DHS group , PFNA group shorter operative time , less blood loss , postoperative ambula