目的: 比较骨水泥灌注联合防旋股骨近端髓内钉（PFNA）内固定及单纯PFNA术治疗骨质疏松性老年股骨粗隆间骨折的疗效。方法: 将我院2019年1月―2021年12月收治的96例骨质疏松性老年股骨粗隆间骨折患者纳入研究,通过随机数字表法分为观察组与对照组,每组各48例。对照组行PFNA内固定治疗,观察组行骨水泥灌注联合PFNA内固定治疗。记录比较两组围术期指标,通过Harris髋关节评分量表对患者术后1个月、3个月、6个月的髋关节功能进行评估,通过视觉模拟评分法（VAS）对患者术前、术后1个月、3个月、6个月的疼痛程度进行评估,记录两组患者术后并发症发生情况,并计算并发症总发生率。结果: 观察组术中出血量、住院时长、术后下地负重时间显著小于对照组,观察组手术时长显著大于对照组,两组术后出血量组间比较无明显差异。与术后1个月比较,观察组与对照组术后3个月、术后6个月Harris评分均有显著升高,且观察组术后1个月、3个月、6个月Harris评分均显著高于对照组。术后1个月、3个月、6个月,观察组与对照组VAS评分较术前均有显著下降,且观察组术后1个月、3个月、6个月VAS评分均显著低于对照组。两组并发症总发生率组间比较无明显差异。结论: 骨水泥灌注联合PFNA内固定治疗骨质疏松性老年股骨粗隆间骨折的疗效优于单纯PFNA治疗,能够显著减少患者术中出血量,缩短患者住院时长、下地负重时长,同时能够有效改善患者髋关节功能,减轻患者疼痛,且具有较高安全性,具有临床应用价值。

Objective To compare the efficacy of bone cement perfusion combined with proximal femoral nail anti-rotation (PFNA) internal fixation and PFNA alone in the treatment of osteoporotic intertrochanteric fractures in the elderly. Methods A total of 96 elderly patients with osteoporotic intertrochanteric fracture admitted to our hospital from January 2019 to December 2021 were included in the study and divided into observation group and control group by random number table method, with 48 cases in each group. The control group was treated with PFNA internal fixation, while the observation group was treated with bone cement perfusion combined with PFNA internal fixation. Recorded and compared the perioperative indicators of the two groups, evaluated the hip function of the patients at 1 month, 3 months and 6 months after operation through Harris Hip scale, evaluated the pain degree of the patients before operation, 1 month, 3 months and 6 months after operation through Visual analogue scale (VAS), recorded postoperative complications in the two groups, and calculated the total incidence of complications. Results The intraoperative blood loss, length of hospital stay and postoperative weight-bearing time in the observation group were significantly lower than those in the control group, and the operation time in the observation group was significantly longer than that in the control group. There was no significant difference in postoperative blood loss between the two groups. Compared with 1 month after operation, the Harris score of the observation group and the control group was significantly increased at 3 months and 6 months after operation, and the Harris score of the observation group was significantly higher than that of the control group at 1 month, 3 months and 6 months after operation. The VAS scores of the observation group and the control group at 1 month, 3 months and 6 months after operation were significantly decreased compared with those before operation, and the VAS scores of the observation group at 1 month, 3 months and 6 months after operation were significantly lower than those of the control group. There was no significant difference in the total incidence of complications between the two groups. Conclusion Bone cement perfusion combined PFNA internal fixation in the treatment of osteoporotic elderly femoral intertrochanteric fracture curative effect is better than that of pure PFNA treatment, patients can significantly reduce intraoperative blood loss, shorten the patients' hospitalization duration, down load time, at the same time can effectively improve the function of patients with hip, relieve patients' pain, and has high security, have clinical application value.