高壓氧聯合PFNA內固定治療股骨粗隆間骨折的臨床效果

【摘要】 目的：探討股骨粗隆間骨折患者采用高壓氧與股骨近端防旋髓內釘（PFNA）內固定聯合治療對其血液流變學、骨密度水平和關節功能恢復情況的臨床影響。方法：從莆田九十五醫院2021年1月—2022年1月收治的股骨粗隆間骨折患者中，選取100例作為研究對象，使用隨機數字表法將其分為對照組和觀察組，每組50例。對照組和觀察組的治療方法分別為PFNA內固定治療及高壓氧聯合PFNA內固定治療，對比兩組治療前后的炎癥因子水平、血液流變學指標、骨密度水平和髖關節功能。結果：治療10 d后，觀察組白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）和C反應蛋白（CRP）指標均較對照組低（Plt;0.05）；觀察組血液黏度、紅細胞聚集指數和紅細胞沉降率均較對照組低（Plt;0.05）；觀察組骨密度水平和Harris髖關節功能評分均較對照組高（Plt;0.05）。結論：股骨粗隆間骨折患者采用高壓氧聯合PFNA內固定治療的效果較顯著，不僅能有效降低炎癥因子水平，改善血液流變學指標，還能提高骨密度水平，促進關節功能的恢復。

【關鍵詞】 股骨粗隆間骨折 高壓氧 股骨近端防旋髓內釘 骨密度 關節功能

Clinical Effect of Hyperbaric Oxygen Combined with PFNA Internal Fixation on Intertrochanteric Fracture of Femur/ZHENG Xiaohua， LIN Weilong， LIN Yuchao， HU Haibo. //Medical Innovation of China， 2023， 20（31）： 0-067

[Abstract] Objective： To investigate the clinical effect of hyperbaric oxygen combined with proximal femoral nail anti-rotation （PFNA） internal fixation on hemorheology， bone mineral density and joint function recovery in patients with intertrochanteric fracture of femur. Method： A total of 100 patients with intertrochanteric fracture of femur admitted to Ninety-five Putian Hospital from January 2021 to January 2022 were selected as the research objects and divided into the control group and the observation group by random number table method， with 50 cases in each group. The treatment methods of the control group and the observation group were PFNA internal fixation， hyperbaric oxygen combined with PFNA internal fixation， respectively. The levels of inflammatory factors， hemorheology indexes， bone mineral density and hip joint function of the two groups were compared before and after treatment.Result： After 10 days of treatment， the levels of interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α） and C reactive protein （CRP） in the observation group were lower than those in the control group （Plt;0.05）; The blood viscosity， erythrocyte aggregation index and erythrocyte sedimentation rate in the observation group were lower than those in control group （Plt;0.05）; the bone mineral density and Harris hip function score of the observation group were higher than those of the control group （Plt;0.05）. Conclusion： Hyperbaric oxygen combined with PFNA internal fixation is effective in the treatment of intertrochanteric fracture of femur， which can not only effectively reduce the level of inflammatory factors， improve the hemorheology index， but also improve the level of bone mineral density and promote the recovery of joint function.

[Key words] Intertrochanteric fracture of femur Hyperbaric oxygen Proximal femoral nail anti-rotation Bone mineral density Joint function

First-author's address： Ninety-five Putian Hospital， Putian 351100， China

doi：10.3969/j.issn.1674-4985.2023.31.015

股骨粗隆間骨折是老年人常見的骨折，以外傷后髖關節疼痛、活動障礙為主要表現，若未能及時得到有效治療，會進一步加重其關節功能損傷程度，影響其生活質量。目前醫學上提倡通過手術治療減輕股骨粗隆間骨折患者的疼痛程度，改善其活動障礙情況，促進其關節功能的恢復。老年粗隆間骨折的治療面臨巨大挑戰，最主要的問題是出血量大、死亡率高、內固定失效、畸形愈合幾方面。……