[1]王建华,林艳,吴永东,等.经皮撬拨复位内固定技术对难复性股骨粗隆间骨折老年患者NE、AngⅡ水平及髋关节功能的影响[J].中华老年骨科与康复电子杂志,2021,(01):9-14.[doi:10.3877/cma.j.issn.2096-0263.2021.01.003]
　Wang Jianhua,Lin Yan,Wu Yongdong,et al.Effect of percutaneous plucking reduction and internal fixation technology on the levels of NE and AngⅡand hip joint function in elderly patients with irreversible intertrochanteric fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2021,(01):9-14.[doi:10.3877/cma.j.issn.2096-0263.2021.01.003]
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经皮撬拨复位内固定技术对难复性股骨粗隆间骨折老年患者NE、AngⅡ水平及髋关节功能的影响()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2021年01期
页码:
9-14
栏目:
股骨骨折
出版日期:
2021-02-05

文章信息/Info

Title:
Effect of percutaneous plucking reduction and internal fixation technology on the levels of NE and AngⅡand hip joint function in elderly patients with irreversible intertrochanteric fractures
作者:
王建华1; 林艳2; 吴永东1; 王有宝1
075000 张家口市第一医院骨一科1；075000 张家口学院护理学院2
Author(s):
Wang Jianhua1;  Lin Yan2;  Wu Yongdong1;  Wang Youbao1
1Department of Bone, Zhangjiakou first hospital, Zhangjiakou 075000, China; 2School of Nursing, Zhangjiakou University, Zhangjiakou 075000, China
关键词:
股骨骨折;  经皮撬拨复位内固定术;  髋关节功能;  去甲肾上腺素;  血管紧张素Ⅱ受体拮抗剂
Keywords:
Femoral fractures;  Percutaneous reduction and internal fixation;  Hip function;  Norepinephrine;  Angiotensin Ⅱ
DOI:
10.3877/cma.j.issn.2096-0263.2021.01.003
文献标志码:
A
摘要:
目的 探讨经皮撬拨复位内固定技术对难复性股骨粗隆间骨折老年患者去甲肾上腺素（NE）、血管紧张素Ⅱ受体拮抗剂（AngⅡ）水平及髋关节功能的影响。方法 选取2018年1月至2020年1月张家口市第一医院收治的102例难复性股骨粗隆间骨折老年患者，按随机数字表法将其分为对照组（n=51）和研究组（n=51）。对照组行PFNA切开复位内固定术，研究组行经皮撬拨PFNA闭合复位内固定术，两组术后均随访2个月。比较两组手术相关指标情况、髋关节优良率及并发症发生情况；对比两组术前、术后1 d的血清NE、AngⅡ水平；统计两组术前、术后1、2个月的Harris评分。结果 研究组手术时间为（46±4）min、切口长度为（5.0±0.5）cm及住院时间为（11.1±1.6）d，均短于对照组[（78±6）min；（12.6±1.4）cm；（12.9±2.8）d，t=31.137；37.955；4.039，P＜0.05）]，术中出血量[（132±27）mL]少于对照组[（156±25）mL，t=4.715，P＜0.05）]。研究组术后1、2个月的髋关节优良率分别为80.39%、94.12%，高于对照组的60.79%、68.63%（t=8.421；9.314，P＜0.05）。与术前比，术后1、2个月，两组Harris评分均呈逐渐递增趋势（F=11.537，F=15.458，P<0.05），且术后1、2个月研究组高于对照组（F=5.824；3.736，P＜0.05）。与术前比，术后1 d，两组血清NE、AngⅡ水平均升高（研究组:t=19.396，12.789；对照组：t=41.450，17.143，P＜0.05），但术后1 d研究组均低于对照组（t=22.705；4.683，P＜0.05）。研究组并发症发生率为5.88%，低于对照组的11.76%（c2=4.126，P＜0.05）。结论 经皮撬拨PFNA闭合复位内固定技术可改善难复性股骨粗隆间骨折老年患者手术相关指标情况，并可降低患者血清NE、AngⅡ水平，减轻骨折损伤，从而有助于改善患者髋关节功能，提高髋关节优良率，且具有较高安全性。
Abstract:
Objective To investigate the effect of percutaneous plucking reduction and internal fixation technology on the levels of norepinephrine (NE) and angiotensin II receptor antagonist, AngⅡ (AngⅡ) and hip joint function in elderly patients with irreversible intertrochanteric fractures. Methods A total of 102 elderly patients with irreversible intertrochanteric fractures treated in our hospital between January 2018 and January 2020 were selected and divided into the control group (n=51) and the observation group (n=51) according to the random number table method. The control group was treated with open reduction and internal fixation, and the study group was treated with percutaneous prying PFNA closed reduction and internal fixation technology. The two groups were followed up for 2 months after operation. The operation-related indicators, the hip joint excellent rate and complications between the two groups were compared, the levels of serum NE and AngⅡ before and after 1 day after operation between the two groups were compared; the score of Harris 1, 2 months after operation were calculated. Results The operation time (46±4) min, incision length (5.0±0.5) cm and hospital stay (11.1±1.6) d in the study group were shorter than that in the control group [(78±6) min; (12.6±1.4) cm; (12.9 ±2.8) d, t=31.137, 37.955, 4.039, P<0.05)], intraoperative blood loss (132±27) mL was less than the control group [(156±25) mL, t=4.715, P<0.05)]. The excellent and good hip joint rate in the study group at 1 and 2 months after surgery were 80.39% and 94.12%, which were higher than the control group at 60.79% and 68.63% (t=8.421, 9.314, P<0.05). Compared with preoperation, the score of Harris in both groups showed a gradually increasing trend at 1 and 2 months post-operation (F=11.537, 15.458, P<0.05), and the study group were higher than the control group at 1 and 2 months after operation (F=5.824, 3.736, P<0.05). Compared with preoperation, the levels of serum NE and AngⅡ increased in the two groups after 1 day (study group, t=19.396, 12.789, control group, t=41.450, 17.143, P<0.05), and the study group were lower than the control group (t=22.705, 4.683, P<0.05). The incidence of complications in the study group was 5.88%, which was lower than the 11.76% in the control group (c2=4.126, P<0.05). Conclusion Percutaneous prying PFNA closed reduction internal fixation technology can improve the surgical indicators of elderly patients with irreversible intertrochanteric fractures, and can reduce the serum NE and Ang Ⅱ levels of patients and reduce fracture injuries, thereby helping to enhance the hip function of patients, improve the excellent rate of hip joints, and have higher safety.

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备注/Memo

备注/Memo:
基金项目：河北省医学科学重点课题（20160248）
更新日期/Last Update: 2021-03-26