老年人髋部骨折662例治疗回顾性分析  

Retrospective analysis of treating 662 cases of elderly hip fracture

作　　者：朱聪 武莉 王大杨 郑傅云 冉健丁 彭安波 毕衡 ZHU Cong;WU Li;WANG Dayang;ZHENG Fuyun;RAN Jianding;PENG Anbo;BI Heng

机构地区：[1]云南中医药大学第一附属医院,云南昆明650000

出　　处：《中医临床研究》2024年第3期76-82,共7页Clinical Journal Of Chinese Medicine

摘　　要：目的:回顾性探讨老年人髋部骨折患者在住院期间髋部骨折的类别、治疗方式的选择以及出现的相关临床并发症。方法:收集云南中医药大学第一附属医院骨伤病区2014年1月1日至2020年11月30日老年髋部骨折患者共662例,其中股骨颈骨折365例(55.1%),股骨粗隆间骨折285例(43.1%),股骨粗隆下骨折12例(1.8%)。结果:662例老年髋部骨折患者中,男性211例(31.9%)、女性451例(68.1%),平均年龄为(77.65±9.616)岁,平均住院天数为(14.00±7.028)d;采用手术治疗的髋部骨折患者462例(69.8%),采用非手术治疗的髋部骨折患者200例(30.2%)。365例股骨颈骨折患者中,采用手术治疗的有267例(73.2%),采用非手术治疗的有98例(26.8%);285例股骨粗隆间骨折患者中,采用手术治疗的有184例(64.6%),采用非手术治疗的有101例(35.4%);12例股骨粗隆下骨折患者中,采用手术治疗的有11例(91.7%),采用非手术治疗的有1例(8.3%)。在选择手术治疗的462例髋部骨折患者中,采用切开复位内固定的有99例(21.4%);采用闭合复位髓内针内固定的有130例(28.1%);采用单纯人工股骨头置换的有156例(33.8%);采用人工全髋关节置换的有77例(16.7%)。在选择非手术治疗的200例髋部骨折患者中,采用保守治疗的有180例(90.0%);采用手法整复的有11例(5.5%);采用皮牵引的有7例(3.5%);采用上腔静脉滤器置入术的有2例(1.0%)。结论:老年人髋部骨折各类型中,股骨颈骨折患者的人数随年龄的增长而增加;高龄患者较易发生股骨粗隆间骨折,且女性比例明显高于男性;而股骨粗隆下骨折较少见。对于大多数髋部骨折的患者来说,手术治疗是目前最主要的治疗方式,对于合并有一种或多种内科基础疾病的患者来说更是如此,并且因为手术方式的多样性,对于肺部感染、静脉血栓形成、泌尿系感染、肺栓塞、呼吸衰竭等并发症的预防和诊治更具针对性。Objective:To retrospectively analyze the classification of hip fracture,the choice of treatment mode and the related clinical complications in elderly patients with hip fracture during hospitalization.Method:A total of 662 elderly patients with hip fractures were collected from the Bone Injury Ward of the First Affiliated Hospital of Yunnan University of traditional Chinese Medicine from January 1,2014 to November 30,2020,including 365 cases of femoral neck fractures(55.1%),285 cases of femoral intertrochanteric fractures(43.1%),and 12 cases of femoral subtrochanteric fractures(1.8%).Results:Among 662 elderly patients with hip fracture,211 were male(31.9%) and 451 were female(68.1%),the mean age was 77.65±9.616 years,and the mean length of hospital stay was 14.00 ±7.028 days.A total of 462 patients(69.8%) with hip fracture were treated by surgery,and 200 patients(30.2%) with hip fracture were treated without surgery.Among 365 cases of femoral neck fracture,267 cases(73.2%) were treated by surgery and 98 cases(26.8%) were treated without surgery.Among 285 cases of intertrochanteric fracture,184 cases(64.6%) were treated by surgery and 101 cases(35.4%) were treated without surgery.Among the 12 patients with subtrochanteric fracture,11 cases(91.7%) were treated by surgery and 1 case(8.3%) was treated without surgery.Of the 462 patients with hip fractures who were treated surgically,99(21.4%) were treated by open reduction and internal fixation;130 cases(28.1%) were treated by closed reduction and intramedullary nail fixation;156 cases(33.8%) were treated by artificial femoral head replacement;total hip arthroplasty was performed in 77 cases(16.7%).Among the 200 patients with hip fractures who chose non-surgical treatment,180 cases(90.0%) were treated conservatively;Manual reduction was used in 11 cases(5.5%);Skin traction was used in 7 cases(3.5%);Superior vena cava filter placement was performed in 2 cases(1.0%).Conclusion:Among all types of hip fractures in the elderly,the number of patients with femoral neck fr

关 键 词：髋部骨折 老年人 治疗方式 并发症 回顾性分析 

分 类 号：R68[医药卫生—骨科学]