DHS与PFNA治疗老年股骨粗隆间骨折的疗效评价

范朝铭

（咸阳市第一人民医院，陕西 咸阳，712000）

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摘要：

目的 比较动力髋螺钉（DHS）内固定与防旋股骨近端髓内钉（PFNA）内固定在老年股骨粗隆间骨折中的应用效果。方法 回顾性分析我院收治的72例老年股骨粗隆间骨折患者的临床资料，将行DHS内固定术的36例患者作为对照组，行 PFNA内固定术的36例患者作为研究组。对比两组患者的手术情况、髋关节功能优良率及术后并发症总发生率。结果 两种方法均取得了较好的临床疗效。其中研究组患者手术时间、术中出血量、下床活动时间、住院时间及骨折愈合时间明显优于对照组（P<0.05）；研究组髋关节功能优良率和并发症总发生率均优于对照组（P<0.05）。结论 PFNA 内固定与DHS 内固定治疗股骨粗隆间骨折均能有效改善患者的髋关节功能，但PFNA 疗效更高，具体应根据患者的手术适应症选择手 术，以促进患者早日康复。

关键词：动力髋螺钉（DHS）；防旋股骨近端髓内钉（PFNA）；股骨粗隆间骨折

中图分类号：R687.3文献标志码：A文章编号：2096-1413(2018)02-0080-02

Therapeutic evaluation of DHS and PFNA in the treatment of femoral intertrochanteric fractures in elder patients
FAN Zhao-ming
(the First People``s Hospital of Xianyang, Xianyang 712000, China)

ABSTRACT: Objective To explore the clinical effect of dynamic hip screw (DHS) and spin proximal femoral intramedullary nailing (PFNA) in the treatment of femoral intertrochanteric fractures on elder patients. Methods The clinical data of 72 elder patients with femoral intertrochanteric fractures were retrospective analyzed, 36 cases with DHS were acted as control group and 36 cases with PFNA were acted as research group. The surgery situation, excellent and good rate of hip joint and total incidence of complications in the two groups were compared. Results Both methods had achieved good clinical efficacy. The operation time, peroperative bleeding, postoperative activity time, hospital stay and healing time of fracture in the research group were absolutely better than those in the control group (P<0.05). The excellent and good rate of hip joint and total incidence of complications in the research group were superior to the control group (P<0.05). Conclusion Both DHS and PFNA in femoral intertrochanteric fractures on elder patients can improve the function of hip joint. But in contrast PFNA have a better clinical efficacy than DHS. The specific surgical options should be take based on the patients`` surgical indications to promote early rehabilitation of patients.
KEYWORDS: dynamic hip screw (DHS); spin proximal femoral intramedullary nailing (PFNA); femoral intertrochanteric fractures

参考文献：
[1] 许英,李琦军.DHS 和PFNA 治疗老年股骨粗隆间骨折比较[J].河北医药,2012,34(3):418-419.
[2] 屈波,伍红桦,邓少林,等.老年股骨粗隆间骨折的手术治疗:应用DHS 与PFNA 的疗效比较[J].军事医学,2014,29(1):67-69.
[3] 谢春龙.DHS 与PFNA 治疗老年股骨粗隆间骨折的临床疗效观察[J].医学理论与实践,2014,27(22):3015-3016.
[4] 段文江,吴宇,赵红军,等.PFNA 与DHS 内固定治疗老年股骨粗隆间骨折疗效比较[J].创伤外科杂志,2013,15(1):41-44.
[5] 拉华欠,李建明,阚玉华,等.PFNA 和DHS 治疗老年股骨粗隆间骨折的临床研究[J].医药前沿,2016,6(25):25-27.
[6] 林少胜,林耿丰.DHS 和PFNA 治疗老年股骨粗隆间骨折临床疗效对比[J].现代医药卫生,2014,30(12):1774-1776.
[7] 吴小杭,彭昌贵,李日旺,等.DHS 和PFNA 治疗老年股骨粗隆间骨折的对比研究[J].现代诊断与治疗,2014,25(18):4264-4265.
[8] 李晓峰.股骨近端防旋髓内钉、动力髋螺钉内固定术治疗老年不稳定型股骨粗隆间骨折效果对比[J].山东医药,2016,56(26):85-87.