- 48 -①江西省宜春市中医院 江西 宜春 336000通信作者：苏川涛人工髋关节置换术与股骨近端髓内钉内固定治疗高龄股骨粗隆间骨折的临床观察黄璐① 刘勇① 涂月① 钟志安① 袁锋① 卢诚① 苏川涛①【摘要】 目的：观察人工髋关节置换术（AHR）与股骨近端髓内钉内固定（PFNA）治疗高龄股骨粗隆间骨折（IFF）的临床效果。
方法：选择2019年5月-2021年4月于宜春市中医院治疗的86例高龄IFF 患者，按随机数字表法将其分为AHR 组与PFNA 组，各43例。
AHR 组采用AHR 治疗，PFNA 组采用PFNA 治疗。
比较两组疼痛程度、骨密度、髋关节功能及并发症发生情况。
结果：AHR 组术后7 d 视觉模拟评分法（VAS）评分低于PFNA 组，术后6个月Harris 评分高于PFNA 组，术后6个月外侧粗隆下骨密度高于PFNA 组，AHR 组髋关节功能恢复优良率高于PFNA 组，差异均有统计学意义（P <0.05）；两组并发症发生率比较，差异无统计学意义（P >0.05）。
结论：高龄IFF 患者采用AHR 治疗有利于减轻疼痛，改善骨密度水平及髋关节功能，且并未增加并发症的发生，安全可靠。
【关键词】 高龄股骨粗隆间骨折 人工髋关节置换术 股骨近端髓内钉内固定 髋关节功能 骨密度 Clinical Observation of Artificial Hip Replacement and Proximal Femoral Nail Fixation in the Treatment of Elderly Femoral Intertrochanteric Fractures/HUANG Lu, LIU Yong, TU Yue, ZHONG Zhian, YUAN Feng, LU Cheng, SU Chuantao. //Medical Innovation of China, 2022, 19(21): 048-051 [Abstract] Objective: To observe the clinical effect of artificial hip replacement (AHR) and proximal femoral nail fixation (PFNA) in the treatment of elderly intertrochanteric fractures (IFF). Method: A total of 86 elderly patients with IFF who treated in Yichun Hospital of Traditional Chinese Medicine from May 2019 to April 2021 were selected and divided into AHR group and PFNA group according to the random number table method, with 43 cases in each group. AHR group was treated with AHR, and PFNA group was treated with PFNA. The pain level, bone mineral density, hip function and complications were compared between two groups. Result: The visual analogue scale (VAS) score in AHR group at 7 d after operation was lower than that in PFNA group, Harris score at 6 months after operation was higher than that in PFNA group, the postoperative lateral subtrochanteric bone mineral density at 6 months after operation was higher than that in PFNA group, the excellent and good rate of hip function recovery in AHR group was higher than that in PFNA group, the differences were statistically significant (P <0.05). There was no significant difference in the incidence of complications between the two groups (P >0.05). Conclusion: AHR treatment in elderly patients with IFF is beneficial to relieve pain, improve bone mineral density and hip joint function, and does not increase the incidence of complications, which is safe and reliable. [Key words] Elderly femoral intertrochanteric fracture Artificial hip replacement Proximal femoral nail fixation Hip joint function Bone mineral density First-author ’s address: Yichun Hospital of Traditional Chinese Medicine, Jiangxi Province, Yichun 336000, China doi：10.3969/j.issn.1674-4985.2022.21.012 股骨粗隆间骨折（IFF）为临床常见髋部骨折，高龄为诱发IFF 最为重要的危险因素[1]。
