PFNA在维持性血液透析患者股骨粗隆间骨折中应用.docVIP

PFNA在维持性血液透析患者股骨粗隆间骨折中应用 　　[摘要] 目的 探讨PFNA治疗维持性血液透析患者粗隆间骨折的方法及疗效。 方法 2010年6月～2014年9月期间对23例维持性血液透析合并粗隆间骨折的患者行PFNA治疗。术前纠正基础疾病；术中闭合复位PFNA固定，记录手术时间、术中出血量；术后预防血栓及功能锻炼，比较术前及术后第1天血红蛋白、白蛋白、肌酐、尿素氮、血钾钙水平等变化。术后1年评估患者的髋关节功能。 结果 23例患者手术时间45～90 min，平均65 min，术中出血量100～400 mL，平均145 mL；术前、术后生化指标变化差异无统计学意义（P0.05）。在对存活的19例患者术后1年的随访评估中，根据Harris髋关节评分分级系统，优5例，较好8例，可5例，差1例。 结论 PFNA治疗维持性血液透析合并粗隆间骨折患者疗效确切，是一种较为理想的内固定治疗方法。 　　[关键词] 维持性血液透析；股骨粗隆间骨折；PFNA；髋关节功能 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2016）21-0059-04 　　[Abstract] Objective To explore the methods and curative effects of PFNA in the treatment of femoral intertrochanteric fracture in patients with maintenance hemolysis. Methods A total of 23 patients with maintenance hemolysis complicated with femoral intertrochanteric fracture were given PFNA therapy from June 2010 to September 2014. Basic diseases were corrected before the surgery； the fractures were closed and replaced and fixed by PFNA during the surgery. Surgery time and amount of bleeding during surgery were recorded； thrombus and functional exercises were prevented after the surgery. Changes of hemoglobin， albumin， creatinine， urea nitrogen， blood potassium and calcium levels were compared before the surgery and one day after the surgery. Patients hip joint function was evaluated one year after the surgery. Results Among the 23 patients， the surgery time was 45-90 min， with an average of 65 min. The amount of bleeding during the surgery was 100-400 mL， with an average of 145 mL； the changes of biochemical indicators before and after the surgery were not significant（P0.05）. In the follow-up evaluation for the 19 survived patients one year after the surgery， according to Harris hip joint grading system， 5 patients were good， 8 patients were fairly good， 5 patients were fair and 1 patient was poor. Conclusion PFNA in the treatment of maintenance hemolysis complicated with femoral intertrochanteric fracture has exact curative effects， which is a relatively ideal therapeuti