甲状旁腺激素辅助老年骨质疏松性股骨转子间骨折术后愈合效果研究

doi:10.3969/j.issn.1003-9198.2021.07.011

摘要/Abstract

摘要： 目的研究甲状旁腺激素辅助治疗老年骨质疏松性股骨转子间骨折术后愈合的临床效果。方法选取我院骨科2019年1～12月采用股骨近端防旋髓内钉(PFNA)手术方式治疗的老年骨质疏松性股骨转子间骨折病人60例,并随机分成2组,每组30例。其中,对照组进行术后骨质疏松基础治疗,试验组在对照组的治疗基础上增加皮下注射甲状旁腺激素20 μg/d的辅助治疗。观察并比较2组手术前后髋关节疼痛程度、Harris功能评分和骨代谢指标等。结果 2组术后髋关节痛感程度明显减轻,Harris 评分及优良率提高,骨折愈合时间缩短,骨密度(BMD)、骨钙素(BGP)水平明显上升,碱性磷酸酶和β-CTX水平显著降低(P<0.05);与对照组相比,试验组改善均更明显(P<0.05)。结论甲状旁腺激素在辅助老年骨质疏松性股骨转子间骨折术后的愈合效果上作用明显,在降低病人术后痛感的同时能够促进骨折愈合和关节功能的恢复。

关键词: 甲状旁腺激素, 骨质疏松性骨折, 老年人, 术后愈合, 骨代谢指标

Abstract: Objective To investigate the clinical efficacy of parathyroid hormone assisted in the elderly patients with osteoporotic fracture in the course of healing. Methods A total of 60 patients with osteoporotic fracture admitted to our hospital from January 2019 to December 2019 were prospectively selected and randomly divided into two groups, with 30 cases in each group. The control group was treated with conservative osteoporosis therapy, and the experimental group were treated with intermittent adjuvant subcutaneous injection of parathyroid hormone 20 μg /d on the basis of the treatment of the control group. The recovery of fracture, bone metabolism index and pain degree and joint function were observed and compared. Results After the operation, the pain of joint was significantly alleviated, the excellent rate of hip Harris score was increased, the fracture healing time was shorter, the levels of bone mineral density (BMD) and bone gla protein (BGP) were increased,while the levels of alkaline phosphatase and β-CrOSSlaps(β-CTX) were decreased significantly in two groups(P<0.05),especially in the experimental group(P<0.05). Conclusions Parathyroid hormone has a significant effect on postoperative healing of osteoporotic fracture, which can reduce postoperative pain and promote fracture healing and joint function recovery.

Key words: parathyroid hormone, osteoporotic fracture, aged, postoperative healing, bone metabolism index

中图分类号:

R 687.3

宋耀东, 姚刚. 甲状旁腺激素辅助老年骨质疏松性股骨转子间骨折术后愈合效果研究[J]. 实用老年医学, 2021, 35(7): 705-708.

SONG Yao-dong. Clinical efficacy of parathyroid hormone in the treatment of elderly patients with osteoporotic intertrochanteric fracture[J]. Practical Geriatrics, 2021, 35(7): 705-708.

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