疾病预防与控制杂志

摘要：目的 对股骨粗隆间骨折老年患者应用股骨近端防旋髓内钉（PFNA）内固定术进行探讨。方法 选择我院 2023 年 5 月至 2024 年 5 月诊治的 66 例老年股骨粗隆间骨折患者，根据随机化法分为两组，联合组和对照组，每组患者 33 例，对照组实施半髋关节置换术，而联合组实施 PFNA 内固定术，比较两组的治疗效果。结果 治疗后，联合组患者在手术用时、出血量、术后引流量以及住院时间等方面均显著少于对照组（P＜0.05）；联合组患者在术后 8 h、24 h、48 h 的视觉模拟评分法（VAS）评分均显著低于对照组（P＜0.05）；联合组患者治疗后感染、步态异常等并发症比对照组少（P＜0.05）。结论 PFNA 内固定术是治疗老年股骨粗隆间骨折的有效手术方式，具有创伤小、固定稳定、手术时间短等优点。术后结合个性化康复训练，能够显著促进患者髋关节功能的恢复，缩短康复时间，提高生活质量，减少术后并发症的发生。

Abstract: Objective To explore the efficacy and rehabilitation outcomes of applying the proximal femoral nail anti-rotation (PFNA) internal fixation in elderly patients with intertrochanteric fractures. Methods Clinical data from 66 elderly patients with intertrochanteric fractures treated in our hospital between May 2023 and May 2024 were selected. Patients were divided into two groups using the random allocation method, there were 33 patients in each of the combined group and the control group. The control group underwent hemiarthroplasty, while the combined group underwent PFNA internal fixation. The treatment outcomes were compared between the two groups. Results After treatment, the combined group showed significantly shorter operative time, less intraoperative blood loss, lower postoperative drainage volume, and shorter hospital stay compared to the control group (P＜0.05). The visual analog scale (VAS) scores at 8 hours, 24 hours, and 48 hours postoperatively were significantly lower in the combined group than in the control group (P＜0.05). The combined group had significantly fewer postoperative complications such as infection and gait abnormality compared to the control group (P＜0.05). Conclusion PFNA internal fixation is an effective surgical approach for treating intertrochanteric fractures in elderly patients. It offers advantages including minimal trauma, stable fixation, and shorter operative time. Combined with individualized rehabilitation training postoperatively, it can significantly promote the recovery of hip joint function, shorten rehabilitation time, improve quality of life, and reduce the incidence of postoperative complications.