老年人髋部骨折围手术治疗  

The perioperative treatments in hip fractures of the elderly

作　　者：孔令英[1] 刘瑞波[1] 白音[1] 

机构地区：[1]北京第六医院,北京100007

出　　处：《中国骨伤》2002年第6期332-334,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨老年人髋部骨折围手术治疗特点。方法　回顾性分析 1992～ 2 0 0 0年我院手术治疗的 72 7例老年髋部骨折病人 ,平均年龄 75岁 ,其中股骨颈骨折 315例 ,股骨转子间骨折 4 12例 ,根据骨折的类型、病人的健康状况选择手术方式。本组中有并存症 6 10例 (83 9% )。主要为心血管疾病、糖尿病、呼吸系统疾病和脑血管病。术前对并存症做适当治疗。术后 3周内并发症主要为 :心律失常、肺部感染、心功能衰竭、腹泻 ,其中大部分病人经积极治疗后康复。死亡 6例 (0 8% )。结果　 315例股骨颈骨折中 2 90例 (92 % )恢复到伤前状态 ,2 5例 (8% )没有达到伤前功能状态。 4 12例股骨转子间骨折 ,374例 (91% )例恢复到伤前状态 ,38例 (9% )效果差。结论　老年人髋部骨折手术治疗是安全有效的方法 ,手术适应症的选择和精心的围手术期治疗是手术治疗成功的关键。Objective To investigate the perioperative treatment characteristics of hip fracture in aged patients Methods 727 cases of hip fracture,with an average age of 75 years were treated by operation from 1992 to 2000;of them,315 cases had femoral neck fracture,412 cases intertrochanteric fractures.610 cases(83 9%)were accompanied with pre existent diseases,mainly cardiovascular diseases,diabetes,chronic respiratory system diseases and cerebro vascular disorders.The operation way was selected,according to the type of fracture and patient's conditions.In preoperative period,the patients with pre existent diseases were treated appropriately.Many patients had post operative complications in three weeks,mainly cardiac arrhythmia,lung infection,heart failure and diarrhea.Most of them recovered promptly after treatment.6 cases(0 8%)were death.Results The results were good in 290 cases(92%)with the femoral neck fracture and 374 cases(91%)with the intertrochanteric fractures,poor in 25 cases(8%)with the femoral neck fracture and 38 cases(9%)with the intertrochanteric fracture.Conclusion If full attention was paid to perioperative treatments,hip fracture of aged patients treated by operation is safe and effective.

关 键 词：髋部骨折 外科手术 骨折愈合 治疗 

分 类 号：R683.305[医药卫生—骨科学]