人工股骨头置换术治疗老年不稳定股骨转子间骨折疗效观察  

Efficacy of Artificial Femoral Head Replacement for Unstable Intertrochanteric Fractures in Elderly Patients

作　　者：崔奎 高进 徐聃 CUI Kui;GAO Jin;XU Dan(Department of Orthopedics,Affiliated Wudang Hospital of Guizhou Medical University,Guiyang Guizhou 550018,China)

机构地区：[1]贵州医科大学附属乌当医院骨科,贵州贵阳550018

出　　处：《中国卫生标准管理》2024年第9期93-96,共4页China Health Standard Management

摘　　要：目的探讨老年不稳定股骨转子间骨折(unstable intertrochanteric fracture of the femur,UITFF)患者实施人工股骨头置换术与防旋型股骨近端髓内钉(proximal femoral antirotation intramedullary nail,PFNA)内固定术的疗效。方法回顾性分析2016年2月—2023年4月贵州医科大学附属乌当医院收治的52例老年UITFF患者,按手术方法的不同分为2组,各26例。对照组实施PFNA内固定术,观察组实施人工股骨头置换术,持续随访3个月。对比2组围手术期指标、Harris髋关节功能评分(Harris hip score,HHS)及并发症。结果观察组术后出血量为(175.74±19.62)mL,多于对照组的(110.06±20.68)mL;手术时间为(63.69±7.11)min,长于对照组的(58.56±5.60)min;术后卧床及住院时间分别为(8.33±1.22)d、(7.65±1.04)d,均短于对照组的(10.44±1.75)d、(10.78±1.46)d(P<0.05)。观察组治疗后HHS量表评分为(72.75±5.66)分,高于对照组的(61.45±4.78)分(P<0.05)。观察组并发症发生率(7.69%)低于对照组(30.77%)(P<0.05)。结论人工股骨头置换术在老年UITFF的治疗中具有更好的应用效果,能够加快患者术后恢复速度,改善髋关节功能,且术后并发症发生风险较低。Objective To investigate the therapeutic effects of artificial femoral head replacement and proximal femoral anti rotation intramedullary nail(PFNA)internal fixation for unstable intertrochanteric fractures of the femur(UITFF)in the elderly.Methods Retrospective analysis of 52 elderly patients with UITFF admitted to Affiliated Wudang Hospital of Guizhou Medical University from February 2016 to April 2023,divided into two groups according to different surgical methods,with 26 cases in each group.The control group underwent PFNA internal fixation surgery,while the observation group underwent artificial femoral head replacement surgery,with a continuous follow-up of 3 months.The perioperative indicators,Harris hip score(HHS)and complications between two groups were compered.Results The postoperative bleeding volume of the observation group was(175.74±19.62)mL,which was higher than that of the control group(110.06±20.68)mL,and the surgical time was(63.69±7.11)min,which was longer than that of the control group(58.56±5.60)min.The postoperative bed rest and hospitalization time were(8.33±1.22)d and(7.65±1.04)d,respectively,which were shorter than those of the control group's(10.44±1.75)d and(10.78±1.46)d(P<0.05).The HHS score of the observation group after treatment was(72.75±5.66)points,which was higher than the control group's(61.45±4.78)points(P<0.05).The incidence of complications in the observation group(7.69%)was lower than that in the control group(30.77%)(P<0.05).Conclusion Artificial femoral head replacement has better results in the treatment of elderly UITFF,it can accelerate postoperative recovery,improve hip function,and have low risk of postoperative complications.

关 键 词：不稳定股骨转子间骨折 人工股骨头置换术 PFNA内固定术 围手术期指标 髋关节功能 并发症 

分 类 号：R687[医药卫生—骨科学]