股骨近端防旋髓内钉联合围手术期护理对高龄股骨粗隆间骨折治疗效果及并发症的影响
The Effect of Proximal Femoral Anti-Rotation Intramedullary Nail Combined with Perioperative Care on the Treatment Effect and Complications of Intertrochanteric Fracture in the Elderly

目的：评估在高龄患者中，通过使用股骨近端防旋髓内钉结合周围手术期的综合护理措施来治疗股骨粗隆间骨折的有效性及安全性。该研究旨在比较传统治疗方法与这种结合治疗方法在改善患者的术后恢复、减少并发症和提高生活质量方面的效果。通过此研究，希望能够为高龄股骨粗隆间骨折患者提供更有效、更安全的治疗方案。方法：回顾性筛选2019年1月至2022年8月于新疆医科大学第六附属医院进行股骨头置换术和股骨骨折闭合复位髓内针内固定术的138例患者，根据治疗方式不同分成2组，对照组患者采用人工股骨头置换术联合围手术期护理干预，65例；观察组患者采用PFNA内固定联合围手术期护理干预，73例，术后随访6月。对比两组患者基本资料，术后住院时间、术后并发症，髋关节Harris功能评分及BI评分等情况。结果：① 术前两组患者的年龄、性别、身体质量指数、患肢、OA分型、手术时间、高血压、糖尿病、心血管疾病、呼吸系统疾病、骨质疏松症等指标进行比较，差异均无显著性意义(P > 0.05)；② 两组患者住院时间、术后并发症肌间静脉血栓、深静脉血栓、肺血栓、切口感染、院内死亡、急性肾功能衰竭、癫痫、严重恶心呕吐和肺部感染的差异无统计学意义(P > 0.05)，但是总并发症发生率差异有统计学意义(P < 0.05)；③ 两组患者与术前比，术后5个月两组患者髋关节Harris功能评分、BI评分均升高，观察组更高，差异均有统计学意义(均P < 0.05)。结论：综上所述，在高龄股骨粗隆间骨折患者的治疗中，应用PFNA内固定联合围手术期护理干预，可以促进髋关节和日常活动能力恢复，并能够减少术后并发症的发生，安全性较高。
Objective: To evaluate the effectiveness and safety of intertrochanteric fractures in elderly patients through the use of proximal femoral anti-rotation intramedullary nails combined with comprehensive care measures during the peripheral surgical period. The study aims to compare the effects of traditional treatments with this combined approach in improving postoperative recovery, reducing complications and improving quality of life. Through this study, it is hoped to provide more effective and safer treatment options for elderly patients with intertrochanteric femoral fractures. Methods: The retrospective screening of 138 patients who underwent femoral head replacement and intramedullary femoral fracture needle fixation in the Sixth Affiliated Hospital of Xinjiang Medical University from January 2019 to August 2022 were divided into 2 groups according to different treatment methods, and the control group patients used artificial femoral head replacement combined with perioperative nursing intervention, 65 cases; the patients in the observation group used PFNA internal fixation combined with perioperative nursing intervention; 73 cases were treated with postoperative follow-up for 6 months. The basic data of the two groups, postoperative hospital stay, postoperative complications, hip Harris function score and BI score were compared. Results: ① The age, sex, body mass index, affected limb, OA classification, operation time, hypertension, diabetes, diabetes mellitus, cardiovascular disease, respiratory disease, osteoporosis and other indicators, none of the differences were significant (P > 0.05); ② There was no significant difference among the duration of hospital stay, postoperative complications, intermuscular venous thrombosis, deep vein thrombosis, pulmonary thrombosis, incision infection, hospital death, acute renal failure, epilepsy,