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目的:观察中西医结合治疗老年股骨转子间骨折的疗效,并分析中医药在手术治疗转子间骨折中的作用。方法:选择2013年3月~2015年7月在海门市中医院治疗的股骨转子间骨折患者80例,根据随机数字分分为单纯手术组和中西医结合治疗组,手术采用股骨近端防旋髓内钉内固定系统进行治疗,中西医结合治疗组辅助中药治疗。对两组患者术中指标,影像学功能及术后髋关节功能进行评估。同时根据相关临床资料分析导致内固定失败的危险因素。结果:术后1年单纯手术组单纯手术组患者TAD值,颈干角均显著高于中西医结合治疗组(P<0.05)。术后1年,两组患者VAS评分,Harris评分以及Parker-Palmer评分差异均无统计学意义(P>0.05)。多因素分析结果表明骨折类型,复位程度,骨骼质量以及切出指数均为老年股骨转子间骨折内固定失败的独立危险因素,其中骨折类型是最重要的影响因素(OR=5.332)。结论:中医药在术后辅助治疗中起到较大作用。导致内固定失败的危险因素包括骨折类型,复位程度,骨骼质量以及切出指数,其中骨折类型为高危因素。
Objective: To observe the effect of integrative traditional Chinese and western medicine on the treatment of intertrochanteric fractures in the elderly, and to analyze the role of Chinese medicine in the treatment of intertrochanteric fractures. Methods: Eighty patients with intertrochanteric fractures treated in Haimen Hospital of Traditional Chinese Medicine from March 2013 to July 2015 were selected. According to the random numbers, 80 patients were divided into simple operation group and integrated traditional Chinese and western medicine group. Intramedullary nailing system for treatment, Integrative Medicine Group assisted traditional Chinese medicine treatment. Two groups of patients intraoperative indicators, imaging and postoperative hip function assessment. At the same time according to the relevant clinical data analysis lead to the failure of internal fixation risk factors. Results: The TAD and neck angle of the surgery group were significantly higher than those of the combination therapy group (P <0.05). One year after operation, there was no significant difference in VAS score, Harris score and Parker-Palmer score between the two groups (P> 0.05). The results of multivariate analysis showed that the type of fracture, the degree of reduction, the quality of bone and the index of incision were independent risk factors for failure of internal fixation of intertrochanteric fractures in the elderly. Fracture type was the most important factor (OR = 5.332). Conclusion: Traditional Chinese medicine plays an important role in postoperative adjuvant therapy. The risk factors for the failure of internal fixation include the type of fracture, the degree of reduction, the quality of bone, and the cut-out index, of which the type of fracture is a risk factor.