人工关节置换术与髓内钉内固定治疗高龄患者股骨转子间骨折的疗效对比  

Comparison of the curative effect of artificial joint replacement and intramedullary nailing in the treatment of intertrochanteric fractures in elderly patients

作　　者：许红林 杨丽花 刘东杰 Xu Honglin;Yang Lihua;Liu Dongjie(The People's Hospital of Yuanjiang County,Yuxi City,Yunnan Province 653300)

机构地区：[1]云南省玉溪市元江县人民医院,653300

出　　处：《中国社区医师》2018年第30期72-73,75,共3页Chinese Community Doctors

摘　　要：目的:分析评价人工关节置换术和股骨近端抗旋髓内钉内固定术治疗高龄不稳定型股骨转子间骨折的疗效。方法:收治高龄股骨转子间骨折患者177例。其中关节置换组84例,髓内钉内固定组93例;比较两种治疗方法在手术时间、术中出血量、术后下地时间、术后并发症发生率及术后Harris评分等方面的指标。结果:关节置换组患者的手术时间(74.44±14.09)min,较髓内钉组(87.76±11.82)min短;术中出血量4.3%/weight,较髓内钉组的5.8%/weight少;术后下地时间(7.67±1.72)d,较髓内钉组(33.52±2.83)d短;平均住院日(19.95±3.66)d,较髓内钉组的(22.71±2.41)d短;平均住院费用(27 525.65±3 628.15)元较髓内钉组的(32 874.40±2 844.16)元少。差异均有统计学意义(P<0.05)。结论:人工关节置换术是治疗高龄不稳定型股骨转子间骨折较合理的手术方法。Objective:To analyze and evaluate the effect of artificial joint replacement and proximal femoral nail anti rotation in the treatment of unstable intertrochanteric fractures in the elderly.Methods:177 elderly patients with intertrochanteric fractures were selected,there were 84 cases in the joint replacement group and 93 cases in the intramedullary nail fixation group.The operative time,intraoperative blood loss,time on getting out of bed after operation,postoperative complication rate and postoperative Harris score were compared between the two treatment methods.Results:The operative time of the joint replacement group(74.44±14.09)min was shorter than that of the intramedullary nail group(87.76±11.82)min,the intraoperative blood loss of 4.3%/weight was less than 5.8%/weight of the intramedullary nail group,the time on getting out of bed after operatio(7.67±1.72)d was shorter than that of the intramedullary nail group(33.52±2.83)d,the average length of hospital stay(19.95±3.66)d was shorter than that of the intramedullary nail group(22.71±2.41)d,the average hospitalization cost(32 874.40±2 844.16)yuan was less than that of the intramedullary nail group(27 525.65±3 628.15)yuan,the differences were all statistically significant(P<0.05).Conclusion:Artificial joint replacement is a reasonable surgical method for the treatment of unstable intertrochanteric fractures in the elderly.

关 键 词：髓内钉内固定 人工关节置换术 股骨转子骨折 高龄 

分 类 号：R687[医药卫生—骨科学]