PFNA围手术期护理对股骨粗隆间骨折治疗效果及并发症的影响

Effect of Peri-Operative Care of PFNA on the Treatment Effect and Complications of Intertrochanteric Femoral Fractures

摘要: 背景：经过对股骨粗隆间骨折治疗方法的深入研究，我们发现采用股骨近端防旋髓内钉结合周围手术期的综合护理措施展现出了显著的治疗有效性和安全性。本研究的核心目的是对比传统治疗方法与这一结合治疗方法在提升患者术后恢复质量、减少并发症发生率以及提高生活质量方面的差异。通过详细的数据分析和案例对比，我们期望能够为股骨粗隆间骨折患者提供一种更为高效、安全的治疗选择，进一步改善患者的生活质量并提升整体治疗满意度。方法：回顾性筛选2021年1月至2023年5月于新疆医科大学第六附属医院进行股骨骨折闭合复位髓内针内固定术的60例患者，根据护理方式不同分成2组，对照组患者采用PFNA内固定联合围手术期常规护理，30例；观察组患者采用PFNA内固定联合围手术期护理干预，30例，术后随访12月以上。结果：① 对术前两组患者的年龄、性别、身体质量指数(BMI)、患肢、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、吸烟史、饮酒史及术前髋关节Harris功能评分、BI评分、视觉模拟评分及Oswestry功能障碍指数等指标进行比较，差异均无显著性意义(P > 0.05)。② 与术前比，术后1天、术后3天、术后7天、术后1个月及术后12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)。③ 与术前比，术后1天、术后3天、术后7天、术后1个月及术后12月两组患者VAS评分及ODI评分均下降，观察组更低，差异均有统计学意义(均P < 0.05)。结论：综上所述，针对高龄股骨粗隆间骨折患者的治疗，采用PFNA (股骨近端防旋髓内钉)内固定联合围手术期护理干预的综合性治疗方案，显著促进了患者髋关节功能的恢复以及日常活动能力的提升。同时，该治疗方案还有效减少了术后并发症的发生，显示出较高的安全性和可靠性，为患者提供了更为优质和有效的治疗选择。

Abstract: Background: After a thorough study on the treatment of intertrochanteric fracture, we found that the proximal femoral intramedullary nail combined with comprehensive nursing measures during the surrounding operation period showed significant therapeutic effectiveness and safety. The core purpose of this study is to compare the differences between traditional treatment methods and this combination in improving the quality of postoperative recovery, reducing the incidence of complications and improving the quality of life. Through detailed data analysis and case comparison, we expect to provide a more efficient and safe treatment option for patients with intertrochanteric femoral fractures, further improving their quality of life and improving overall treatment satisfaction. Methods: 60 patients with closed reduction of intramedullary needle fixation in the Sixth Affiliated Hospital of Xinjiang Medical University from January 2021 to May 2023 were retrospectively screened and divided into 2 groups according to the different nursing methods, control group patients with PFNA internal fixation combined with perioperative routine care, 30 cases; patients in observation group with PFNA internal fixation combined with perioperative nursing intervention, 30 cases, postoperative follow-up for more than 12 months. Results: ① Preoperative age, sex, body mass index (BMI), affected limb, surgery, hypertension, diabetes, cardiovascular disease, respiratory disease, osteoporosis, smoking, drinking history and preoperative hip Harris function score, BI score, visual simulation score, and Oswestry dysfunction index of two groups were compared, no significant difference (P > 0.05). ② Compared with the preoperative results, the hip Harris function score and BI scores of both groups increased 1 day, 3 days, 7 days, 1 month and 12 months after surgery, and the observation group was higher (both P < 0.05). ③ Compared with the preoperative results, VAS and ODI scores of both groups decreased 1 day, 3 days, 7 days, 1 month and 12 months after surgery, and the observation group was lower, and the difference was significant (P < 0.05). Conclusion: In conclusion, for the treatment of elderly patients with intertrochanteric fracture, the comprehensive treatment program of PFNA internal fixation (proximal femoral intramedullary nail) combined with perioperative nursing intervention, significantly promoted the recovery of hip function and the improvement of daily activities. At the same time, the treatment regimen also effectively reduces the occurrence of postoperative complications, showing high safety and reliability, and provides patients with more high-quality and effective treatment options.