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目的:探讨InterTan髓内钉联合股方肌蒂骨瓣移植治疗老年髋部骨折的疗效及其对血清B型尿钠肽（BNP）、纤维蛋白原（FIB）和1型前胶原氨基末端前肽（P1NP）水平的影响。方法:收集2016年1月至2018年12月本院就诊的老年髋部骨折患者78例，均为股骨颈骨折。随机数字表法分为对照组和观察组，各39例。对照组行空心螺钉内固定治疗，观察组行InterTan髓内钉联合股方肌蒂骨瓣移植治疗。比较两组的治疗效果及治疗前后血清BNP、FIB和P1NP水平。结果:对照组手术时间、切口长度、术中出血量、住院时间和骨折愈合时间均显著优于观察组（均n P<0.05）。观察组和对照组治疗优良率分别为84.62%（33/39）、61.54%（24/39），观察组显著高于对照组（n χ2=5.278，n P<0.05）。与术前比较，术后1个月、6个月和12个月两组视觉模拟评分（VAS）均显著降低，日常生活活动能力（ADL）评分均显著升高（均n P<0.05）；且随着时间延长，两组术后VAS评分逐渐降低，ADL评分逐渐升高。术后1个月、6个月和12个月，观察组ADL评分均显著高于对照组（均n P0.05）。观察组和对照组术后并发症总发生率分别为15.38%（6/39）、38.46%（15/39），观察组显著低于对照组（n χ2=5.278，n P<0.05）。术后24 h、48 h、72 h两组血清BNP、FIB水平较术前均显著升高（均n P<0.05），且术后不同时点血清BNP和FIB水平均呈逐渐升高趋势；术后不同时点观察组血清BNP、FIB较对照组均显著降低（均n P<0.05）。术后3个月、6个月、12个月两组血清P1NP呈现出先升高后降低的趋势。术后3个月、6个月两组血清P1NP较术前均显著升高，且观察组均显著高于对照组（均n P0.05）。n 结论:InterTan髓内钉联合股方肌蒂骨瓣移植治疗老年髋部骨折较空心螺钉内固定术操作难度大、手术时间长、术中损伤也更大，但术后恢复情况更好，手术并发症的发生率更低，可作为一种较好的手术方案供临床选择。“,”Objective:To investigate the efficacy of InterTan intramedullary nail combined with quadratus femoris muscle pedicle bone flap grafting as a treatment of hip fractures and its influence on serum levels of B-type natriuretic peptide (BNP) , fibrinogen (FIB) and procollagen type 1 amino-terminal propeptide (P1NP) in elderly patients.Methods:A total of 78 elderly patients with hip fracture patients treated in our hospital between January 2016 and December 2018 were enrolled. All the patients had femoral neck fractures. According to random number table, they were divided into the control group and study group (n=39 each) . The control group was treated with hollow screw internal fixation, while the study group was treated with InterTan intramedullary nail internal fixation combined with quadratus femoris muscle pedicle bone flap grafting. The treatment efficacy and serum levels of BNP, FIB and P1NP before and after treatment were compared between the two groups.Results:The operation time, incision length, intraoperative blood loss, length of hospital stay and time to fracture healing were significantly shorter or lower in the control group than those in the study group (all n P<0.05) . The rates of excellent and good treatment efficacy in the study group and control group were 84.62% (33/39) and 61.54% (24/39) , respectively, with significantly higher rates in the study group compared with the control group (n χ2=5.278, n P<0.05) . Compared with before surgery, the visual analogue scale (VAS) scores were significantly lower, and the activity of daily living (ADL) scores were significantly increased, in either group at 1, 6 and 12 months after surgery (alln P<0.05) . Over time, the VAS scores gradually decreased, and the ADL scores gradually increased in either group. At 1, 6 and 12 months after surgery, the ADL scores were significantly higher in the study group than those in the control group (alln P0.05) . The overall incidence rates of postoperative complications in the study group and the control group were 15.38% (6/39) and 38.46% (15/39) , respectively, with significantly lower rates in the study compared with the control group (n χ2=5.278, n P<0.05) . The levels of serum BNP and FIB in the two groups were significantly higher at 24 h, 48 h, and 72 h after surgery than those before surgery (alln P<0.05) . The serum levels of BNP and FIB at different time points after surgery showed an upward trend. At any given time point after surgery, the serum levels of BNP and FIB were significantly lower in the study group than those in the control group (alln P<0.05) . At 3, 6 and 12 months after surgery, the serum P1NP level in the two groups tended to increase initially and then decrease afterwards. In either group, the serum levels of P1NP were significantly higher at 3 and 6 months after surgery than that before surgery, and with significantly higher level in the study group compared with the control group (alln P0.05) .n Conclusion:InterTan intramedullary nail internal fixation combined with quadratus femoris muscle pedicle bone flap grafting as a treatment of hip fractures in the elderly is more difficult than hollow screw internal fixation, with longer operation time, more surgical trauma, but as well with better postoperative recovery and fewer surgical complications, and therefore can be used as a good surgical option for clinical decision-making.