两种术式治疗高龄不稳定股骨转子间骨折的临床效果评价  

Clinical Evaluation of two Surgical Methods for the Treatment of UnstableIntertrochanteric Fracture in Elderly Patients

作　　者：付永刚 FU Yonggang(Hospital of Luannan County,Tangshan,Hebei 063500,China)

机构地区：[1]河北省唐山市滦南县医院,河北唐山063500

出　　处：《大医生》2020年第14期29-31,共3页Doctor

摘　　要：目的分析采取人工股骨头置换术治疗方案及股骨近端防旋髓内钉的治疗方案对患有不稳定股骨转子间骨折的老年患者进行治疗的效果。方法选取河北省唐山市滦南县医院2017年7月至2019年9月接诊的100例不稳定股骨转子间骨折的高龄患者,按照随机数字表法分为对照组与试验组,每组50例,对照组采取股骨近端防旋髓内钉手术方案,试验组采取人工股骨头置换术方案。对比两组患者治疗前、治疗后多个指标,根据髋关节功能评分(Harris)对两组患者术后1、3个月及术后6个月的髋关节功能情况比较,同时对比两组患者髋关节功能优良率。结果试验组患者平均手术时间、评价术中出血量高于对照组,第一次下床活动时间、住院时间、骨折愈合时间及并发症发生率显著低于对照组;试验组患者的髋关节功能优良率高于对照组;试验组术后1、3、6个月的Harris评分优于对照组,差异有统计学意义(P<0.05)。结论在为不稳定股骨转子间骨折的高龄患者进行治疗时,股骨近端防旋髓内钉手术方式更为理想,具有手术创伤小、固定牢固、骨折愈合时间短、内固定并发症少等优点,患者可早期下地负重,且髋关节功能恢复良好。Objective To analyze the effect of artificial femoral head replacement and proximal femoral nail antirotation on elderly patients with unstable intertrochanteric fracture.Methods A total of 100 elderly patients with unstable intertrochanteric fracture in Hospital of Luannan County from July 2017 to September 2019 were selected and randomLy divided into control group and experimental group,50 cases in each group.The control group was treated with proximal femoral nail antirotation surgery,and the experimental group was treated with artificial femoral head replacement.Comparison of two groups of patients before and after treatment of multiple indicators,according to Harris score of two groups of patients with surgery 1,3 months and half a year after the hip function were compared,and the excellent and good rate of hip joint function of the two groups were compared.Results The average operative time and the amount of blood loss during evaluation were higher in the experimental group than in the control group,and the first time out of bed activity,hospital stay,fracture healing time and the incidence of complications were significantly lower in the experimental group than in the control group.The rate of hip joint function in experimental group was higher than that in control group.Harris scores of the experimental group at 1,3 and 6 months after surgery were better than those of the control group,with statistically significant differences(P<0.05).Conclusion In the treatment of elderly patients with unstable intertrochanteric fracture,proximal femoral nail antirotation surgery is more ideal,with advantages of small surgical trauma,firm fixation,short fracture healing time,less internal fixation complications,patients can be early weight-bearing,and hip joint function recovery is good.

关 键 词：人工股骨头置换手术 股骨近端防旋髓内钉 不稳定股骨转子间骨折 

分 类 号：R68[医药卫生—骨科学]