136例老年高能量股骨转子间骨折的临床治疗分析  

Clinical treatment of high-energy intertrochanteric femur fracture for elderly patients:an analysis of 136 cases

作　　者：郑江[1] 赵平[1] 陈尔东[1] 李开南[1] 

机构地区：[1]成都大学附属医院骨科/成都市创伤骨科研究所,610081

出　　处：《临床外科杂志》2016年第5期353-355,共3页Journal of Clinical Surgery

摘　　要：目的明确高能量股骨转子间骨折对老年患者的影响。方法高能量创伤老年患者319例,排除伴有外伤性脑损伤及伴有神经症状的脊柱损伤患者。分为骨折组及对照组:骨折组136例,有股骨转子间骨折,平均年龄(70.84±8.06)岁。对照组183例,无股骨转子间骨折,平均年龄(69.09±7.64)岁。记录患者的住院死亡率,6个月及1年死亡率,并发症,ICU时间,住院时间,出院情况,伴随骨折,手术干预情况。采用x^2检验、Fisher's精确概率法、t检验、KaplanMeier评估法以及Cox回归分析对数据进行分析。结果两组间住院死亡率、6个月死亡率、1年死亡率比较,差异无统计学意义(P>0.05)。高能量股骨骨折的老年患者并发症增加(P<0.05),多伴有长骨骨折(P<0.05)和非长骨骨折(P<0.05),更多需要外科手术治疗(P<0.05),住院时间较长(P<0.05),两组患者平均ICU天数相似。结论高能量股骨转子间骨折增加了老年患者的并发症发生率,但并没有增加死亡率。对这一群体,伴随损伤可能发挥着更为重要的作用。Objective To evaluate the effect of high-energy intertrochanteric femur fracture on elderly patients. Methods A total of 319 patients with high-energy intertrochanteric femur fracture were enrolled. Patients with traumatic brain injury or spine injury with a neurologic deficit were excluded. The patients were divided into the fracture group and control group. There were 136 cases in the fracture group [ average age, （70.84 ± 8.06 ） years I and 183 cases in the control group [ average age, （ 69.09 ± 7.64 ） years 3. In-hospital mortality, 6-month and 1 -year mortality, complications, ICU and total hospital stay, dis- charge disposition, accompanying fractures, surgical intervention, and covariates were recorded. Chi-square test, Fisher＇s exact test, Student＇s t test, Kaplan-Meier analysis, and Cox regression models were performed for statistical analyses. Results There were significant differences in the complications, total hospital stay, discharge disposition, accompanying fractures, surgical intervention between the two groups （ P 〈 0.05 ）. There were no significant differences in the in-hospital mortality ,6-month and 1-year mortality, and ICU stay between the groups （ P 〉 0.05 ）. Conclusion High-energy intertrochanteric femur fracture in- creased complications in elderly patients;however, no increase in mortality was observed in our patients. Concomitant injuries may play a more critical role in the population.

关 键 词：高能量股骨转子间骨折 老年 比较 

分 类 号：R683[医药卫生—骨科学]