不同手术体位在治疗老年创伤性股骨粗隆间骨折中临床疗效研究  

Clinical effect of different surgical posture in treatment of traumatic intertrochanteric fracture in elderly

作　　者：柯威 旷瑜 闵竟 郑华[1] KE Wei;KUANG Yu;MIN Jing;ZHENG Hua(Department of Orthopedics,Yongchuan Hospital,Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院骨科,重庆402160

出　　处：《创伤与急危重病医学》2021年第1期56-59,共4页Trauma and Critical Care Medicine

摘　　要：目的探讨单边截石位、仰卧剪刀位和侧卧位等手术体位对老年创伤性股骨粗隆间骨折的临床疗效。方法选取自2018年1月至2019年12月重庆医科大学附属永川医院收治的225例股骨粗隆间骨折老年患者为研究对象。按照手术体位法分为截石位组、仰卧位组及侧卧位组,每组75例。术中均采用亚洲型股骨近端防旋髓内钉(PFNA-Ⅱ)治疗,比较3组的手术时间、术中透视时间、术中出血量、术后并发症发生率、骨折愈合时间及髋关节功能Harris评分优良率。结果3组患者的术中出血量、骨折愈合时间、并发症发生率及髋关节功能Harris评分优良率比较,差异均无统计学意义(P>0.05)。截石位组的手术时间、术中透视时间均短于仰卧位组、侧卧位组,差异有统计学意义(P<0.05)。结论PFNA-Ⅱ术式采用单边截石位、仰卧剪刀位及侧卧位治疗老年创伤性股骨粗隆间骨折效果较好,术后并发症少。而截石位术中透视时间及手术时间较短,可降低反复透视对医患的危害,缩短手术时间。Objective To investigate the clinical effect of unilateral lithotomy position,supine scissor position and lateral decubitus position in the treatment of elderly traumatic intertrochanteric fracture.Methods A retrospective study was performed on 225 cases of patients with elderly traumatic intertrochanteric fracture who were admitted January 2018 to December 2019.According to different surgical positions,patients were divided into the lithotomy position group,supine scissor position group and lateral decubitus position group,with 75 cases in each group.Asian type proximal femoral nail antirotation(PFNA-Ⅱ)was used intraoperatively,the operation time,intraoperative fluoroscopy time,intraoperative blood loss,incidence of postoperative complications,fracture healing time,and excellent and good rate of Harris score of hip joint function were compared among the 3 groups.Results There was no statistically significant difference in intraoperative blood loss,fracture healing time,incidence of complications and excellent and good rate of Harris score of hip joint function among 3 groups(P>0.05).The operative time and intraoperative fluoroscopy time in the lithotomy position group were shorter than those in the supine position group and the lateral decubitus position group,and the difference was statistically significant(P<0.05).Conclusion PFNA-Ⅱhas better effect and less postoperative complications in the treatment of elderly traumatic intertrochanteric fracture with unilateral lithotomy position,supine scissors position and lateral decubitus position.The time of fluoroscopy and operation in lithotomy position is shorter,which can reduce the harm of repeated fluoroscopy to doctors and patients and shorten the operation time.

关 键 词：股骨粗隆间骨折 老年 创伤性 体位 亚洲型股骨近端防旋髓内钉 

分 类 号：R687.3[医药卫生—骨科学]