鲑降钙素阿法骨化醇碳酸钙联合的应用治疗骨质疏松性股骨粗隆间骨折40例疗效分析.docVIP

鲑降钙素阿法骨化醇碳酸钙联合的应用治疗骨质疏松性股骨粗隆间骨折40例疗效分析 　　摘 要 目的：比较鲑降钙素、阿法骨化醇、碳酸钙联合应用与单用鲑降钙素治疗骨质疏松性股骨粗隆间骨折的临床疗效。方法：将80例行闭合复位PFNA内固定术治疗的骨质疏松性股骨粗隆间骨折患者，随机分为实验组及对照组。分别给予肌注鲑降钙素+口服阿法骨化醇和碳酸钙和单纯肌注鲑降钙素。治疗6个月及1年后测定骨密度值及观察骨折愈合时间并进行比较。结果：实验组治疗6个月和1年后腰椎和股骨颈，Ward三角及大转子4个部位BMD较对照组均显著上升（P0.05）。实验组与对照组比较，骨折愈合时间有显著性差异。结论：闭合复位PFNA内固定术治疗骨质疏松性股骨粗隆间骨折后，给予肌注鲑降钙素+口服阿法骨化醇和钙剂可显著提高患者的骨密度，缩短骨折的愈合时间，明显优于单纯给予肌注鲑降钙素的疗效。 　　关键词 骨质疏松 股骨粗隆间骨折 阿法骨化醇 随机对照研究 　　中图分类号：R977； R969.4 文献标识码：B 文章编号：1006-1533（2013）09-0024-04 　　Evaluation of therapeutic effect of salmon calcitonin， alfacalcidol， calcium 　　carbonate in the treatment of 40 cases of osteoporotic intertrochanteric fractures 　　WANG Sicheng， LIU Xiangfei， WU Xianmin， HE Jinguo， ZHANG Youzhong， YAN Guoqing 　　（Department of Orthopaedic Surgery， Shanghai Zhongye Hospital， Shanghai 200160， China） 　　ABSTRACT Objective： To study the clinical efficacy of a monotherapy of salmon calcitonin or a combination therapy of salmon calcitonin with alfacalcidol and calcium carbonate on osteoporotic intertrochanteric fracture. Methods： Eighty patients with osteoporotic intertrochanteric fractures who received a reduction and internal fixation with PFNA were randomly divided into either experimental group or control one. Patients in experimental group were administrated with intramuscular salmon calcitonin plus oral alfacalcidol and calcium carbonate while only intramuscular salmon calcitonin was given in control group. BMD was measured again after 6 months or 1 year treatment， and fracture healing time was observed. The obtained data were statistically analyzed. Results： BMD of lumbar spine， neck of femur， trochiter and Ward’s triangular area were more significantly increased in experimental group than in control group （P0.05）. The comparisons of fracture healing time between two groups showed significant differences. Conclusion： After closed reduction and internal fixation of PFNA in osteoporotic intertrochanteric fracture， combination therapy of intramuscular salmon calcito