本文選題：PFNA　切入點：LISS鋼板　出處：《寧夏醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的探討PFNA與倒置LISS鋼板治療A2型股骨粗隆間骨折臨床療效,對A2型股骨粗隆間骨折的治療及預后評價提供更好的臨床依據。方法回顧性分析自2012年8月至2016年2月間就診于寧夏醫(yī)科大學總醫(yī)院創(chuàng)傷骨科并接受PFNA與倒置LISS鋼板治療的A2型股骨粗隆間骨折40例患者的臨床資料,其中3例失訪,37例患者獲得全程隨訪。男19例,女18例,年齡48-69歲,平均年齡(58.6±10.4)歲。其中18例采用PFNA內固定,19例行倒置LISS內固定,收集兩組手術時間(從手術開始到手術結束,包括術中透視時間)、術中出血量、術后切口引流量、手術切口長度、住院時間、術后負重時間、骨折愈合時間、術后并發(fā)癥(髖內翻程度、內固定失敗率、肺部感染、深靜脈血栓形成及股骨頭壞死)、術后Harris評分的數據,通過統(tǒng)計學分析對其療效進行比較。結果37例獲全程隨訪患者,隨訪時間為12~18個月,平均約14個月。PFNA組與倒置LISS鋼板組手術時間分別為(62.4±10.3)、(103.5±16.7)min,術中出血量分別為(175.4±31.6)、(283.7±27.4)ml,術后切口引流量分別為(69.3±6.5)、(125.4±5.8)ml,手術切口長度分別為(6.2±1.3)、(7.2±1.9)cm,住院時間分別為(7.1±1.2)、(7.3±1.1)天,術后負重時間分別為(17.8±1.6)、(38.0±2.4)天,骨折愈合時間分別為(12.2±1.9)、(11.1±2.3)周。兩組手術時間、術中出血量、切口長度、術后負重時間、引流量、并發(fā)癥及髖關節(jié)功能恢復方面比較有顯著性差異(P0.05),在住院時間及骨折愈合時間方面比較無顯著性差異(P0.05)。結論PFNA與倒置LISS鋼板治療A2型股骨粗隆間骨折都可以得到讓人滿意的療效。在A2型股骨粗隆間骨折的治療方面PFNA內固定要優(yōu)于倒置LISS鋼板固定,具有手術時間短、創(chuàng)傷小、出血量少、臥床時間短、并發(fā)癥少等優(yōu)點,有顯著的臨床療效,值得推廣。
[Abstract]:Objective to investigate the clinical effect of PFNA and inverted LISS plate in the treatment of type A2 intertrochanteric fracture of femur. To provide better clinical basis for the treatment and prognosis evaluation of type A2 intertrochanteric fracture. Methods from August 2012 to February 2016, a retrospective analysis was conducted in the Department of Trauma and Orthopaedics, Ningxia Medical University General Hospital, and received PFNA and inverted LISS. Clinical data of 40 patients with A2 type intertrochanteric fracture treated with steel plate. Three of them were followed up for the whole course. There were 19 males and 18 females, aged 48 to 69 years, with an average age of 58.6 鹵10.4 years. Among them, 18 cases were treated with PFNA internal fixation and 19 cases were treated with inverted LISS internal fixation, and the operation time was collected from the beginning of operation to the end of operation. It includes time of fluoroscopy, amount of blood lost during operation, drainage of incision after operation, length of incision, length of hospital stay, time of weight bearing after operation, time of fracture healing, postoperative complications (degree of hip varus, failure rate of internal fixation, pulmonary infection). The data of Harris score after operation were compared by statistical analysis. Results 37 patients were followed up for 12 ~ 18 months. The mean operation time was 62.4 鹵10.3 鹵16.7 min, the intraoperative bleeding volume was 175.4 鹵31.6 鹵27.4 ml, the incision drainage volume was 69.3 鹵6.5 鹵5.8ml, the incision length was 6.2 鹵1.3U / h 7.2 鹵1.9cm, the hospitalization time was 7.1 鹵1.21g / kg 鹵1.1) days, and the postoperative weight loading time was 17.8 鹵1.6 鹵2.4m / min, respectively, and the operative incision length was 6.2 鹵1.3U / min 鹵1.9cm, respectively, and the length of the incision was 6.2 鹵1.3U / L 鹵1.9mm. the hospital stay was 7.1 鹵1.21.2U / min, respectively, and the postoperative weight loading time was 17.8 鹵1.6 / kg / kg / kg, 38.0 鹵2.4m / d, respectively, and the operative incision length was 6.2 鹵1.3U / min (7.2 鹵1.9cm), and the hospital stay was 7.1 鹵1.2U / min 鹵1.1g / min. The healing time of fracture was 12.2 鹵1.9 and 11.1 鹵2.3 weeks respectively. There were significant differences in complications and hip function recovery (P 0.05), but there was no significant difference in hospital stay and fracture healing time. Conclusion both PFNA and inverted LISS plate can be used to treat A2 type intertrochanteric fracture of femur. PFNA internal fixation is superior to inverted LISS plate fixation in the treatment of type A2 intertrochanteric femoral fractures. It has the advantages of short operation time, less trauma, less bleeding, shorter bed-rest time and less complications. It has remarkable clinical effect and is worth popularizing.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

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