[1]莫钟才,李　彦,符方涛.不同时期应用阿仑膦酸钠片对老年股骨颈骨折患者全髋关节置换术后关节功能和骨密度的影响[J].新乡医学院学报,2021,38(3):281-284.[doi:10.7683/xxyxyxb.2021.03.016]
　MO Zhongcai,LI Yan,FU Fangtao.Effect of alendronate sodium tablets in different application periods on the joint function and bone density in elderly patients with femoral neck fracture after total hip arthroplasty[J].Journal of Xinxiang Medical University,2021,38(3):281-284.[doi:10.7683/xxyxyxb.2021.03.016]
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不同时期应用阿仑膦酸钠片对老年股骨颈骨折患者全髋关节置换术后关节功能和骨密度的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年3
页码:
281-284
栏目:
临床研究
出版日期:
2021-03-05

文章信息/Info

Title:
Effect of alendronate sodium tablets in different application periods on the joint function and bone density in elderly patients with femoral neck fracture after total hip arthroplasty
作者:
莫钟才1; 李　彦2; 符方涛1
（1.定安县人民医院创伤骨科，海南　定安　571200；2.海南医学院第二附属医院创伤骨科，海南　海口　570311）
Author(s):
MO Zhongcai1; LI Yan2; FU Fangtao1
(1.Department of Orthopedics and Trauma,Ding′an People′s Hospital,Ding′an 571200,Hainan Province,China2.Department of Orthopedics and Trauma,the Second Affiliated Hospital of Hainan Medical University,Haikou 570311,Hainan Province,China)
关键词:
股骨颈骨折; 全髋关节置换术; 阿仑膦酸钠片; 关节功能; 骨密度
Keywords:
femoral neck fracturetotal hip arthroplastyalendronate sodium tabletsjoint functionbone density
分类号:
R687.4
DOI:
10.7683/xxyxyxb.2021.03.016
文献标志码:
A
摘要:
目的　探讨不同时期应用阿仑膦酸钠片对老年股骨颈骨折（FNF）患者全髋关节置换术后关节功能及骨密度的影响。方法　选择2018年10月至2019年10月定安县人民医院收治的92例老年FNF患者为研究对象，所有患者行全髋关节置换术，根据术后阿仑膦酸钠片应用时期将患者分为观察组和对照组，每组46例。观察组患者术后第3周开始给予阿仑膦酸钠片治疗3个月，对照组患者术后第13周开始给予阿仑膦酸钠片治疗3个月。术后2周及3、6个月，采用Harris评分量表评估患者髋关节功能优良率，应用Hologic双能X线骨密度仪检测假体周围感兴趣区（ROI）1、ROI 2、ROI 3、ROI 4、ROI 5、ROI 6、ROI 7的骨密度；观察2组患者治疗期间不良反应发生情况。结果　观察组患者术后2周及3、6个月髋关节功能优良率分别为17.39%（8/46）、73.91%（34/46）、91.30%（42/46）；对照组患者术后2周及3、6个月髋关节功能优良率分别为15.22%（7/46）、41.30%（19/46）、71.74%（33/46）；2组患者术后3、6个月髋关节功能优良率显著高于术后2周，术后6个月髋关节功能优良率显著高于术后3个月（P＜0.05）；2组患者术后2周髋关节功能优良率比较差异无统计学意义（P＞0.05）；术后3、6个月，观察组患者髋关节功能优良率显著高于对照组（P＜0.05）。2组患者术后3、6个月ROI 1、ROI 6和ROI 7的骨密度显著低于术后2周（P＜0.05）；2组患者术后3个月ROI 2、ROI 3、ROI 5的骨密度显著低于术后2周，术后6个月骨密度显著高于术后2周和3个月（P＜0.05）。术后2周和3个月，2组患者ROI 1、ROI 2、ROI 3、ROI 4、ROI 5、ROI 6及ROI 7的骨密度比较差异无统计学意义（P＞0.05）。术后6个月，观察组患者ROI 1、ROI 2、ROI 3、ROI 5、ROI 6及ROI 7的骨密度显著高于对照组（P＜0.05）2组患者ROI 4的骨密度比较差异无统计学意义（P＞0.05）。观察组和对照组患者不良反应发生率分别为10.87%（5/46）、8.70%（4/46），2组患者不良反应发生率比较差异无统计学意义（χ2=0.123，P＞0.05）。结论　相比术后晚期应用阿仑膦酸钠片，全髋关节置换术后早期应用阿仑膦酸钠片更有助于改善老年FNF患者的髋关节功能，提高骨密度。
Abstract:
Objective　To investigate the effect of alendronate sodium tablets in different application periods on the joint function and bone density in elderly patients with femoral neck fracture (FNF) after total hip arthroplasty.Methods　　A total of 92 elderly patients with FNF admitted to Ding′an People′s Hospital from October 2018 to October 2019 were selected as the research subjects.All patients underwent total hip arthroplasty and the patients were divided into observation group and control group according to the postoperative application period of alendronate sodium tablets,with 46 cases in each group.The patients in the observation group were treated with alendronate sodium tablets for three months from the third week after operation,while the patients in the control group were treated with alendronate sodium tablets for three months from the thirteenth week after operation.At two weeks and three and six months after operation,the fineness rate of hip joint function was evaluated by Harris score;the bone density of region of interest (ROI) 1,ROI 2,ROI 3,ROI 4,ROI 5,ROI 6 and ROI 7 around the prosthesis was measured by Hologic dual energy X-ray absorptiometry.The adverse reactions of patients in the two groups were observed during the treatment.Results　At two weeks and three and six months after operation,the fineness rate of hip joint function in the observation group was 17.39% (8/46),73.91% (34/46) and 91.30% (42/46),respectively;while the fineness rate of hip function in the control group was 15.22% (7/46),41.30% (19/46) and 71.74% (33/46),respectively.The fineness rate of hip joint function at three and six months after operation was significantly higher than that at two weeks after operation,and the fineness rate of hip joint function at six months after operation was significantly higher than that at three months after operation (P＜0.05).There were no significant difference in the fineness rate of hip joint function between the two groups at two weeks after operation (P＞0.05).At three and six months after operation,the fineness rate of hip joint function in the observation group was significantly higher than that in the control group (P＜0.05).The bone density of ROI 1,ROI 6 and ROI 7 at three and six months after operation was significantly lower than that at two weeks after operation in the two groups (P＜0.05).The bone density of ROI 2,ROI 3 and ROI 5 at three months after operation was significantly lower than that at two weeks after operation,and the bone density at six months after operation was significantly higher than that at two weeks and three months after operation in the two groups (P＜0.05).There was no significant difference in the bone density of ROI 1,ROI 2,ROI 3,ROI 4,ROI 5,ROI 6 and ROI 7 between the two groups at two weeks and three months after operation (P＞0.05).The bone density of ROI 1,ROI 2,ROI 3,ROI 5,ROI 6 and ROI 7 in the observation group was significantly higher than that in the control group at six months after operation (P＜0.05);there were no significant difference in the bone density of ROI 4 between the two groups.The incidence of adverse reactions in the observation group and the control group was 10.87% (5/46) and 8.70% (4/46),respectively.There was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.123,P＞0.05).Conclusion　Compared with the late application of alendronate sodium tablets,early application of alendronate after total hip arthroplasty is more helpful to improve the hip function and bone density in elderly patients with FNF.

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更新日期/Last Update: 2021-03-05