本文關(guān)鍵詞： PFNA 老年股骨粗隆間骨折 臨床療效 影響因素　出處：《河北醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:股骨粗隆間骨折是臨床上常見的疾病,這種疾病發(fā)病率較高,且在老年人群中比較常見,隨著我國(guó)人口老齡化的不斷加劇,股骨粗隆間骨折發(fā)生率出現(xiàn)上升趨勢(shì)。患者發(fā)病后主要以疼痛、喪失下床活動(dòng)能力、需要家屬長(zhǎng)期護(hù)理、導(dǎo)致原有心腦血管疾病加重等為特點(diǎn),影響患者正常生活和工作。目前,臨床上對(duì)于股骨粗隆間骨折治療方法相對(duì)較多,常見的包括:LCP(股骨近端鎖定鋼板)內(nèi)固定和PFNA內(nèi)固定等,這些方法均能夠有效的改善患者癥狀,提高臨床療效。但是,臨床上對(duì)于不同治療方法在老年股骨粗隆間骨折中的療效尚存在較大的爭(zhēng)議。同時(shí),患者PFNA內(nèi)固定手術(shù)后早期療效的影響因素研究也相對(duì)較少。因此,臨床上研究PFNA內(nèi)固定治療老年股骨粗隆間骨折術(shù)后早期療效的影響因素具有重要的意義。方法:選取2013年09月至2014年12月在我院(冀中能源峰峰集團(tuán)總醫(yī)院)因股骨粗隆間骨折手術(shù)治療的80例老年患者資料進(jìn)行分析,根據(jù)采用內(nèi)固定方案不同將患者分為L(zhǎng)CP組和PFNA組,比較兩組患者臨床治療后手術(shù)時(shí)間、術(shù)中出血量、住院時(shí)間以及術(shù)后愈合時(shí)間、并發(fā)癥等指標(biāo),分析患者PFNA治療老年股骨粗隆間骨折術(shù)后早期療效的影響因素。結(jié)果:兩組患者的性別、年齡、受傷原因、身高、體重以及內(nèi)科合并癥情況,組間差異不存在統(tǒng)計(jì)學(xué)意義(P0.05);PFNA組手術(shù)時(shí)間、術(shù)中出血量、住院時(shí)間以及切口長(zhǎng)度、術(shù)后愈合時(shí)間,顯著少于LCP組,差異存在統(tǒng)計(jì)學(xué)意義(P0.05);PFNA組4例出現(xiàn)并發(fā)癥,并發(fā)癥發(fā)生率為10%,顯著低于LCP組(11例出現(xiàn)并發(fā)癥,并發(fā)癥發(fā)生率為27.5%),差異存在統(tǒng)計(jì)學(xué)意義;PFNA組治療后Harris髖關(guān)節(jié)功能評(píng)分,顯著高于LCP組,差異存在統(tǒng)計(jì)學(xué)意義(P0.05);PFNA組治療后負(fù)重時(shí)間,顯著短于LCP組,差異存在統(tǒng)計(jì)學(xué)意義(P0.05);采用強(qiáng)迫進(jìn)入的方法進(jìn)行回歸分析,建立多元線性回歸分析方程。方差分析顯示F=15.621,P0.05,有統(tǒng)計(jì)學(xué)意義,表明髖關(guān)節(jié)功能和T值、BMI、負(fù)重時(shí)間、及是否伴有小粗隆骨折有線性關(guān)系。R方=0.652 R=0.835,表明早期髖關(guān)節(jié)功能和是否存在小粗隆骨折、T值、BMI和患者負(fù)重時(shí)間相關(guān)程度高,標(biāo)準(zhǔn)化系數(shù)中骨密度值和負(fù)重時(shí)間的絕對(duì)值最大,表明如果患者骨密度值較好,采取早期負(fù)重的方法,可以獲得較高的髖關(guān)節(jié)功能評(píng)分。結(jié)論:(1)PFNA和LCP不同治療方法在老年股骨粗隆間骨折患者中均能取得理想效果。但是和LCP相比,PFNA更具微創(chuàng)性,對(duì)患者創(chuàng)傷更小,能夠更好的改善患者關(guān)節(jié)功能。(2)PFNA治療老年股骨粗隆間骨折術(shù)后早期的髖關(guān)節(jié)功能和骨密度、負(fù)重時(shí)間、是否存在小粗隆骨折、BMI指數(shù)有密切相關(guān)性。
[Abstract]:Objective: intertrochanteric fracture of femur is a common disease in clinic. The incidence of this disease is high and it is more common in the elderly population. The incidence of intertrochanteric fracture of the femur is on the rise. The main characteristics of the patients are pain, loss of the ability to get out of bed, the need for long-term care of the family, leading to the exacerbation of the original cardiovascular and cerebrovascular diseases. At present, there are many clinical treatment methods for intertrochanteric fracture of femur, such as: LCP (proximal locking plate of femur) internal fixation and PFNA internal fixation. These methods can effectively improve the symptoms of patients and improve the clinical efficacy. However, there is still a greater controversy about the efficacy of different treatment methods in the elderly femoral intertrochanteric fractures. At the same time. There are few factors influencing the early outcome of PFNA internal fixation in patients. It is of great significance to study the factors influencing the early curative effect of PFNA internal fixation in the treatment of senile intertrochanteric fracture. Methods: from September 2013 to December 2014, we selected (. The data of 80 elderly patients with intertrochanteric fracture of femur were analyzed. The patients were divided into LCP group and PFNA group according to the internal fixation plan. The time of operation, intraoperative bleeding, hospital stay and postoperative healing time, complications were compared between the two groups. Results: sex, age, cause of injury, height, weight and complications of the two groups were analyzed. There was no significant difference between the two groups (P 0.05). The operative time, intraoperative bleeding, hospital stay and incision length in PFNA group were significantly less than those in LCP group, and the difference was statistically significant (P 0.05). Complications were found in 4 cases in PFNA group (10%), which was significantly lower than that in LCP group (11 cases). The incidence of complications was 27.5% (P < 0.05). The score of Harris hip function in PFNA group was significantly higher than that in LCP group (P 0.05). The weight bearing time after treatment in PFNA group was significantly shorter than that in LCP group, and the difference was statistically significant (P 0.05). The multiple linear regression equation was established by using forced entry method. The variance analysis showed that there was significant difference in the function of hip joint and T value in the analysis of variance. There was a linear relationship between BMI, weight loading time, and whether or not there was a small trochanter fracture. The results showed that the function of hip joint and the T value of small trochanter fracture existed in the early stage. The correlation between BMI and weight bearing time was high, and the absolute value of bone mineral density and weight bearing time was the largest in the standardized coefficient, which indicated that if the patient had better BMD value, the method of early loading should be adopted. Conclusion the different treatments of LCP and FNA can achieve good results in elderly patients with intertrochanteric fracture of femur, but compared with LCP. PFNA is more minimally invasive, less traumatic to the patients, can improve the joint function of the patients with better treatment of elderly patients with intertrochanteric fracture of hip function, bone mineral density, weight bearing time. There is a close correlation between BMI index and small trochanteric fracture.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 范忠明;曹陽(yáng);伍瓚;湯炳旺;;PFNA治療老年股骨粗隆間骨折[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2009年02期

2 劉興華;王劍;李健;;PFNA治療老年股骨粗隆間骨折[J];基層醫(yī)學(xué)論壇;2009年10期

3 何敏;王凌志;;PFNA治療老年股骨粗隆間骨折的手術(shù)配合[J];中國(guó)實(shí)用醫(yī)藥;2009年30期

4 喬榮勤;羅毅文;萬(wàn)雷;程英雄;;股骨近端復(fù)雜骨折的PFNA治療[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2010年10期

5 楊興桃;;PFNA治療高齡股骨轉(zhuǎn)子間骨折[J];中國(guó)現(xiàn)代醫(yī)生;2010年30期

6 蔣海平;劉磊;張雷炎;談俊;王勇;;PFNA在老年股骨粗隆間骨折治療中的應(yīng)用[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2011年02期

7 常樹松;張健;李娜;滕家松;沙憲輝;喬添柱;;防旋股骨近端髓內(nèi)釘(PFNA)微創(chuàng)技術(shù)治療老年骨質(zhì)疏松性股骨粗隆間骨折的回顧性療效分析[J];中國(guó)傷殘醫(yī)學(xué);2011年04期

8 馬小明;;PFNA治療老年股骨粗隆間骨折[J];齊齊哈爾醫(yī)學(xué)院學(xué)報(bào);2011年14期

9 楊正祿;楊開舜;;PFNA治療老年性股骨粗隆間骨折的療效觀察[J];中外醫(yī)學(xué)研究;2011年25期

10 程志濱;劉宇;馬小明;;PFNA治療老年股骨粗隆間骨折20例[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2012年01期

相關(guān)會(huì)議論文 前10條

1 李科倫;黃忠勝;胡凱;趙政;;PFNA治療高齡股骨轉(zhuǎn)子間骨折的療效分析[A];2009年浙江省骨科學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2009年

2 李科倫;黃忠勝;胡凱;趙政;;PFNA治療高齡股骨轉(zhuǎn)子間骨折的療效分析[A];第七屆全國(guó)創(chuàng)傷學(xué)術(shù)會(huì)議暨2009海峽兩岸創(chuàng)傷醫(yī)學(xué)論壇論文匯編[C];2009年

3 郭禮躍;黃維琛;李路;呂翔;孟映福;;PFNA治療高齡股骨轉(zhuǎn)子間骨折62例臨床報(bào)道[A];貴州省中西醫(yī)結(jié)合學(xué)會(huì)骨傷分會(huì)第二次學(xué)術(shù)交流會(huì)議論文匯編[C];2011年

4 蔣新艷;;PFNA治療老年股骨粗隆間骨折的手術(shù)配合[A];創(chuàng)建患者安全文化——中華護(hù)理學(xué)會(huì)第15屆全國(guó)手術(shù)室護(hù)理學(xué)術(shù)交流會(huì)議論文匯編（下冊(cè)）[C];2011年

5 陳文輝;甘俊松;張正茂;蔣賽;;PFNA一Ⅱ微創(chuàng)治療高齡股骨轉(zhuǎn)子間骨折[A];2012年浙江省骨科學(xué)術(shù)年會(huì)論文集[C];2012年

6 江淮;呂建軍;許俊勝;程文丹;曹慶;吳小三;;應(yīng)用PFNA治療老年骨質(zhì)疏松性股骨粗隆間骨折[A];中華醫(yī)學(xué)會(huì)第七次全國(guó)骨質(zhì)疏松和骨礦鹽疾病學(xué)術(shù)會(huì)議論文匯編[C];2013年

7 樂(lè)軍;彭亮;呂建華;項(xiàng)東;;PFNA治療老年股骨粗隆間骨折療效及并發(fā)癥[A];2009年浙江省骨科學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2009年

8 朱宗昊;李凡;王秋根;李豪青;陶杰;高偉;黃建華;;PFNA治療老年不穩(wěn)定性股骨轉(zhuǎn)子周圍骨折68例[A];第二屆泛長(zhǎng)江流域骨科新進(jìn)展研討會(huì)暨上頸椎傷病新理論新技術(shù)學(xué)習(xí)班論文匯編[C];2008年

9 戶小彬;王大衛(wèi);張津生;曾憲鐵;;PFNA結(jié)合中醫(yī)治療老年股骨粗隆間骨折的臨床體會(huì)[A];第二十屆全國(guó)中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會(huì)、第二屆中國(guó)醫(yī)師協(xié)會(huì)中西醫(yī)結(jié)合醫(yī)師分會(huì)骨傷科學(xué)術(shù)年會(huì)、第十九屆浙江省中西醫(yī)結(jié)合骨傷科專業(yè)委員會(huì)學(xué)術(shù)年會(huì)論文匯編[C];2013年

10 戶小彬;王大衛(wèi);張津生;;微創(chuàng)PFNA結(jié)合中醫(yī)治療老年股骨粗隆間骨折[A];第三屆全國(guó)中西醫(yī)結(jié)合骨科微創(chuàng)學(xué)術(shù)交流會(huì)論文匯編[C];2013年

相關(guān)碩士學(xué)位論文 前8條

1 銀曉永;PFNA治療老年股骨粗隆間骨折術(shù)后早期療效分析[D];河北醫(yī)科大學(xué);2015年

2 胡楊;PFNA治療老年人股骨轉(zhuǎn)子間骨折[D];重慶醫(yī)科大學(xué);2012年

3 王添;PFNA治療老年股骨粗隆間骨折的臨床研究[D];山東中醫(yī)藥大學(xué);2011年

4 王思元;PFNA治療老年股骨粗隆間骨折的初步經(jīng)驗(yàn)[D];山東中醫(yī)藥大學(xué);2011年

5 許京偉;微創(chuàng)PFNA治療老年股骨粗隆間骨折的臨床療效觀察[D];山東中醫(yī)藥大學(xué);2012年

6 梁虎;PFNA在老年股骨粗隆間骨折中的療效分析[D];延邊大學(xué);2012年

7 黃漫華;股骨轉(zhuǎn)子間骨折PFNA固定術(shù)后隱性失血及其相關(guān)因素的研究[D];廣州中醫(yī)藥大學(xué);2015年

8 陳朝;PFNA-Ⅱ與InterTan髓內(nèi)釘治療股骨轉(zhuǎn)子間骨折對(duì)比分析[D];廣州中醫(yī)藥大學(xué);2015年

，

本文編號(hào)：1486550