人工股骨头置换与内固定治疗高龄患者股骨粗隆间骨折的疗效比较  

Comparative Study on the Effects of Hip Hemiarthroplasty and Internal Fixation in the Treatment of Intertrochanteric Fracture in Elderly Patients

作　　者：田科良[1] 余黎明[1] 朱健[1] 张绪华[1] 张克云[1] 张仁明[1] 林昕[1] 瞿哲[1] 

机构地区：[1]湖南怀化医专附属医院暨怀化市第三人民医院骨科,湖南怀化418000

出　　处：《医学临床研究》2008年第9期1618-1621,共4页Journal of Clinical Research

摘　　要：【目的】对比分析人工股骨头置换术和内固定术治疗高龄患者股骨粗隆间骨折的临床疗效,评价两种手术治疗方案的优劣。【方法】选取2002年1月至2008年2月本院收治的高龄股骨粗隆间骨折患者74例,其中应用人工股骨头置换术治疗42例,内固定术治疗32例。对两组患者的术前合并症、手术时间、术中失血量、住院时间、卧床时间、术后并发症等临床指标以及术后患侧髋关节功能评价进行统计学分析。【结果】随访6个月至5年,平均3.3年。两组患者的术前合并症和骨折类型差异无显著性(P>0.05),而手术时间、术中失血量、住院时间、卧床时间、术后并发症发生率及患侧髋关节功能评价均显示股骨头置换组优于内固定组,两组间差异均有显著性(P<0.05)。【结论】人工股骨头置换术治疗高龄患者股骨粗隆间骨折操作相对简单、创伤小,避免了骨折不愈合及内固定失效等问题,同时具有卧床时间短,术后恢复快,并发症发生率低,功能恢复好等优点。可作为临床治疗高龄股骨粗隆间骨折一种较为理想的选择。[Objective]To comparatively analyze the clinical effects of hemiarthroplasty（HA） and internal fixation in the treatment of intertrochanteric fractures in aged patients and to evaluate the merits and defects of the two methods. [Methods]From January 2002 to February 2008, 74 elderly patients with intertrochanteric fractures were chosen at random. Forty two cases were treated with hemiarthroplastY and 37 cases were treated with internal fixation. The clinical data of the two groups such as the preoperative coexisting diseases, du ration of operation, intraoperative blood loss. duration of hospitalization, ambulation time, postoperative com plications and the function evaluation of affected hip joint after operanon were collected for statistical analysis. [Results]The average follow-up rime was 3.3 years ranged from 6 months to 5 years. In comparison of the preoperative coexisnng diseases and the fracture classification, there was no significant difference between the two groups （ P 〉0.05）. While in comparison of the duration of operation, intraoperative blood loss, duration of hospitalization, ambulation time. the rate of postoperative complications and the function evaluation of affected hip joint, it showed that hemiarthroplasty was superior to internal fixation dramatically, and the difference between the two groups was significant（ P 〈0.05）. [Conclusion ]Hemiarthroplasty is an effective and satisfactory method to treat intertroehanterie fracture in aged patients. It can avoid nonunion and internal fixation failure and has the advantages of shorter ambulation time. quicker recovery after operation, less rate of complications, etc. It can be a rational option for treatment of intertrochanteric fractures in senile patients.

关 键 词：股骨颈骨折/外科学 关节成形术 置换 髋 骨折固定术 内 

分 类 号：R683.42[医药卫生—骨科学]