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目的:比较标准骨水泥强化型股骨近端防旋髓内钉(PFNA)与传统PFNA治疗老年骨质疏松性股骨转子间不稳定骨折的疗效。方法:采用回顾性病例对照研究分析2017年6月至2018年5月浙江中医学大学附属温州中西医结合医院收治的68例老年骨质疏松性股骨转子间不稳定骨折患者的临床资料,其中男27例,女41例;年龄68~96岁[(85.0±6.6)岁]。32例患者接受标准骨水泥强化型PFNA治疗(骨水泥组),36例患者接受传统PFNA治疗(传统组)。比较两组手术时间、术中出血量、尖顶距值、骨折愈合时间、术后并发症情况、术后2周及12个月起立行走(TUG)试验时间、术后12个月髋关节功能Harris评分。结果:患者均获随访12~16个月[(14.0±1.3)个月]。骨水泥组手术时间[(56.3±8.7)min]、术中出血量[(163.6±21.3)ml]、尖顶距值[(26.3±1.2)mm]、骨折愈合时间[(12.2±1.9)周]、术后12个月TUG试验时间[(20.6±3.1)s]及术后12个月Harris评分[(89.6±5.8)分]与传统组比较[(52.7±7.9)min、(154.8±22.6)ml、(26.8±1.3)mm、(12.5±2.0)周、(21.4±2.6)s及(88.5±6.5)分],差异均无统计学意义(n P>0.05)。末次随访时患者均获骨性愈合。骨水泥组术后并发症发生率为9%(尿路感染1例,术后谵妄2例),传统组为31%(尿路感染2例,肺部感染2例,术后谵妄1例,螺旋刀片切击2例,螺旋刀片松动退钉3例)(n P<0.05)。术后2周骨水泥组TUG试验时间[(81.4±10.2)s]显著短于传统组[(90.8±13.7)s](n P0.05). At the latest follow-up, bone union was observed in all patients. The incidence of postoperative complications in cement group was 9% (urinary tract infection in 1 patient, postoperative delirium in 2), while that in conventional group was 31% (urinary tract infection in 2 patients, lung infection in 2, postoperative delirium in 1, spiral blade cutting in 2, screw blade loosening and nailing back in 3) (n P<0.05). However, the result of TUG test in cement group [(81.4±10.2)seconds] was significantly shorter than that in conventional group [(90.8±13.7)seconds] at postoperative 2 weeks (n P<0.05).n Conclusion:Compared to conventional PFNA, standard bone cement augmented PFNA for treatment of elderly osteoporotic patients with femoral inter-trochanteric unstable fractures can reduce the incidence of complications and promote the recovery of early walking ability.