高龄患者股骨转子间不稳定型骨折Ⅰ期实施人工加长柄股骨头置换术的疗效分析  

An analysis of the effect of artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture

作　　者：陈占星 崔海勇[1] 胡永军[1] 胡海[1] 代建昊 范亮亮[1] 陈启刚[1] 蒋维利[1] 赵龙飞[2] 何晓地 陶钧[1] 许克庆[1] 曾兆波 冷月[1] 邢晓丽[1] 余金素[1] 董斌[1] 

机构地区：[1] 蚌埠医学院第四附属医院(淮南市第一人民医院)骨科,安徽省淮南232007 [2] 安徽理工大学临床医学院,安徽省淮南232007

出　　处：《中国基层医药》2017年第20期3062-3066,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：安徽省淮南市科技计划项目（2015-1569）

摘　　要：目的 分析Ⅰ期人工加长柄股骨头置换术治疗高龄股骨转子间不稳定型骨折的疗效.方法 选择203例高龄不稳定型股骨转子间骨折患者,进行Ⅰ期人工加长柄股骨头置换术治疗,其中男性65例,女性138例,统计入院时、术后2周、术后随访时患肢的harris评分、SF-36、VAS疼痛评分法的评分结果.对比3个时间段患者的患肢疼痛情况及髋关节评分等.结果 203例高龄患者均获得随访,手术平均时阔为83.64 min,术中出血量为355.41 mL,按照harris评分、SF-36、VAS疼痛评分法的评分标准进行疗效评价,入院时、术后2周、术后随访时患肢的harris评分结果分别为：（28.26±5.50）分、（68.26±5.50）分、（93.13±5.31）分,差异均有统计学意义（t=-71.27、-1397.55、-46.07,均P＜0.01）;VAS疼痛评分结果分别为：（8.19±0.48）分、（3.53±0.71）分、（0.42士0.23）分,差异均有统计学意义（t=88.06、324.17、60.84,均P＜0.01）;SF-36评分分别为：生理（8.35±1.24）分、（15.23±2.17）分、（19.21±2.12）分,社会/家庭（7.01±1.13）分、（14.12±2.12）分、（19.85±2.24）分,情感：（4.83±1.01）分、（10.12±1.22）分、（14.87±1.32）分,功能：（6.35±1.21）分、（13.67±1.87）分、（16.81±2.12）分,附加关注：（8.85±1.45）分、（16.38±2.12）分、（20.21±2.42）分,生活质量总分：（47.35±4.76）分、（74.69±5.87）分、（89.21士6.12）分,差异均有统计学意义（t=-39.77、-62.92、-20.21、-44.87、-71.89、-26.79、-45.04、-89.01、-38.25、-45.79、-63.41、-15.29、-45.20、-60.39、-17.54、-52.12、-76.49、-22.58,均P＜0.05）.结论 选择Ⅰ期人工加长柄股骨头置换术治疗高龄患者股骨转子间不稳定型骨折有很好的临床效果,术中安全性较高,术后并发症较少,术后患肢功能恢复良好,值得临床推广应用.Objective To analyze of the effect of artificial lengthening femoral head replacement in elderly patients with stage Ⅰ of unstable femoral intertrochanteric fracture.Methods 203 patients with stage Ⅰ of unstable femoral intertrochanteric fracture were selected as the research object,and they were taken artificial lengthening femoral head replacement,among which 65caese were male,female in 138 cases.The Harris scoring,SF-36,VAS pain scores on admission,2 weeks after operation,postoperative follow-up limb were counted,and the pain of the affected limb and the hip scores were compared amond 3 time periods.Results All 203 cases of senile patients with follow-up,average operation time was 83.64 minutes,the intraoperative blood loss was 355.41mL.The curative effect was evaluated according to the Harris score,SF-36 and VAS pain scoring criteria,and the Harris scores of the affected limbs at admission,at 2 weeks after the operation and after the follow-up were （28.26 ± 5.50） points,（68.26 ±5.50） points,（93.13 ± 5.31） points,respectively,the differences were statistically significant （t =-71.27,-1 397.55,-46.07,all P 〈 0.01）;The VAS pain scores were （8.19 ± 0.48） points,（3.53 ± 0.71） points,（0.23 ± 0.42） points,respectively,the differences were statistically significant （t =88.06,324.17,60.84,all P 〈 0.01）.The sf-36 scores：physiological [（8.35 ± 1.24） points,（15.23 ± 2.17） points,（19.21 ± 2.12） points],social/family [（7.01 ±1.13） points,（14.12 ± 2.12） points,（19.85 ± 2.24） points],emotional [（4.83 ± 1.01） points,（10.12 ±1.22）points,（14.87 ± 1.32） points],function [（6.35 ± 1.21） points,（13.67 ± 1.87） points,（16.81 ±2.12） points],additional focus [（8.85 ± 1.45） points,（16.38 ± 2.12） points,（20.21 ± 2.42） points],total quality of life [（47.35 ± 4.76） points,（74.69 ± 5.87） points,（89.21 ± 6.12） points],the differences were statistically significant（-39.77,-62.92,-20.21,-44.87,-71.89,-26.7

关 键 词：股骨骨折 关节成形术 置换 髋 老年人 

分 类 号：R687.3[医药卫生—骨科学]