高龄股骨转子间骨折患者行DAA人工股骨头置换术的可行性报告  

Feasibility report of DAA of artificial femoral head replacement in elderly patients with intertrochanteric fracture of femur

作　　者：刘玉坤 袁军 宾梦翔 江涛 LIU Yu-kun;YUAN Jun;BIN Meng-xiang(Liuyang Orthopedic Hospital,Liuyang 410300,China)

机构地区：[1]浏阳市骨伤科医院,410300

出　　处：《中国实用医药》2024年第8期6-10,共5页China Practical Medicine

摘　　要：目的 浅析高龄股骨转子间骨折患者采取直接前入路(DDA)人工股骨头置换术的可行性,以便为日后临床制定适宜的治疗方案提供参考。方法 60例高龄股骨转子间骨折患者,依据手术入路不同分为对照组与观察组,各30例。两组均行人工股骨头置换术,对照组接受传统后外侧入路,观察组接受DAA。比较两组患者手术相关指标(手术时间、术中失血量、术后下地时间)以及术后各时间段的髋关节功能、疼痛评分。结果 观察组患者术后下地时间(3.29±1.02)d短于对照组的(5.74±1.08)d,且术中失血量(132.64±21.84)ml少于对照组的(156.75±24.78)ml,差异有统计学意义(P<0.05);两组患者手术时间相比,差异无统计学意义(P>0.05)。观察组术后1周、2周、1个月及3个月髋关节功能评分分别为(67.98±2.04)、(79.67±1.62)、(87.86±1.97)、(92.27±1.31)分,均高于对照组的(61.54±1.92)、(71.80±2.14)、(85.27±2.24)、(89.78±1.42)分,差异有统计学意义(P<0.05)。观察组患者术后24、72 h疼痛评分分别为(4.01±0.89)、(2.09±0.58)分,均低于对照组的(4.62±0.86)、(2.78±0.52)分,差异有统计学意义(P<0.05)。结论 对于高龄股骨转子间骨折患者开展DAA人工股骨头置换术具有积极意义,可有效改善患者髋关节功能,缓解疼痛程度,具有良好的推广价值。Objective To analyze the feasibility of direct anterior approach(DAA)of artificial femoral head replacement in elderly patients with intertrochanteric fracture of femur,so as to provide reference for the development of appropriate treatment plans for future clinic.Methods 60 elderly patients with intertrochanteric fracture of femur were divided into a control group and an observation group according to different surgical approaches,with 30 patients in each group.Both groups underwent artificial femoral head replacement,with traditional posterolateral approach in the control group,and DAA approach in the observation group.The operation-related indexes(operation time,intraoperative blood loss,postoperative ambulation time),hip function and pain score at different postoperative time periods of the two groups were compared.Results The observation group had shorter postoperative ambulation time of(3.29±1.02)d than(5.74±1.08)d in the control group,and less intraoperative blood loss of(132.64±21.84)ml than(156.75±24.78)ml in the control group.The difference was statistically significant(P<0.05).There was no significant difference in operation time between the two groups(P>0.05).The hip function scores of the observation group were(67.98±2.04),(79.67±1.62),(87.86±1.97)and(92.27±1.31)points at 1 week,2 weeks,1 month and 3 months postoperatively,which were higher than(61.54±1.92),(71.80±2.14),(85.27±2.24)and(89.78±1.42)points in the control group,and the difference was statistically significant(P<0.05).The pain scores in the observation group were(4.01±0.89)and(2.09±0.58)points at 24 and 72 h postoperatively,which were lower than(4.62±0.86)and(2.78±0.52)points in the control group,and the difference was statistically significant(P<0.05).Conclusion DAA of artificial femoral head replacement is of positive significance for elderly patients with intertrochanteric fracture of femur,which can effectively improve the hip joint function and relieve the pain,and has good promotion value.

关 键 词：高龄 股骨转子间骨折 直接前入路 人工股骨头置换术 

分 类 号：R687.3[医药卫生—骨科学]