人工全髋关节置换术治疗Evans-JensenⅢ型股骨转子间骨折的效果观察  

Effect of Total Hip Arthroplasty on Evans-jensen Type Ⅲ Femoral Intertrochanteric Fracture

作　　者：王春亮 WANG Chunliang(Department of orthopedics,Tianjin port hospital,Tianjin 300456)

机构地区：[1]天津港口医院骨科,天津300456

出　　处：《中国伤残医学》2024年第4期68-71,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨人工全髋关节置换术(THA)治疗Evans-JensenⅢ型股骨转子间骨折的效果.方法:选择2021年1月-2022年10月在我院进行手术治疗的84例Evans-JensenⅢ型股骨转子间骨折患者作为研究对象,随机将其分为对照组与观察组,各42例.观察组采用THA治疗,对照组采用股骨近端髓内钉内固定手术治疗,比较2组围手术期指标、疼痛视觉模拟(VAS)评分、血流动力学变化与并发症发生情况.结果:观察组的手术时间、术后住院时间及切口长度均短于对照组,术中出血量均少于对照组,组间差异有统计学意义(P<0.05).术后1、3、7 d,观察组的VAS评分均低于对照组,差异有统计学意义(P<0.05).术后7 d,观察组血小板聚集指数、血浆比黏度均低于对照组,组间差异有统计学意义(P<0.05).观察组术后1、2、3个月的髋关节Harris评分均高于对照组,差异有统计学意义(P<0.05).观察组并发症发生率为4.76%,低于对照组的19.05%,差异有统计学意义(P<0.05).结论:THA治疗Evans-JensenⅢ型股骨转子间骨折能提升患者康复速度,缓解疼痛,调节血液流变学指标,减少并发症的发生,促进髋关节功能的恢复.Objective:To investigate the effect of total hip replacement(THA)in the treatment of Evans-Jensen type Ⅲ femoral intertrochanteric fracture.Methods:84 patients with Evans-Jensen type Ⅲ intertrochanteric fracture who underwent surgical treatment in our hospital from January 2021 to October 2022 were selected as the study objects,and randomly divided into a control group and an observation group,with 42 cases in each group.The observation group was treated with THA,while the control group was treated with proximal femoral intramedullary nail and internal fixation.Perioperative indexes,pain visual analogue score(VAS),hemodynamic changes and complications were compared between the two groups.Results:The operation time,postoperative hospitalization time and incision length in the observation group were shorter than those in the control group,and the intraoperative blood loss and was less than that in the control group,with statistical significance between the two groups(P<0.05).1,3 and 7 d after operation,the VAS scores of the observation group were lower than those of the control group,and the difference between the two groups was statistically significant(P<0.05).7 d after operation,the platelet aggregation index and plasma specific viscosity in the observation group were lower than those in the control group,and the differences were statistically significant between the two groups(P<0.05).1,2 and 3 months after operation,the hip Harris scores of the observation group were higher than those of the control group,and the difference was statistically significant between the two groups(P<0.05).The incidence of complications in the observation group was 4.76%,which was lower than 19.05%in the control group,and the difference was statistically significant(P<0.05).Conclusion:THA treatment of Evans-Jensen type Ⅲ femoral intertrochanteric fracture can improve the recovery speed,relieve pain,regulate hemorheology indexes,reduce the occurrence of complications,and promote the recovery of hip function.

关 键 词：股骨转子间骨折 观察组 血液流变学指标 人工全髋关节置换术 并发症发生率 血流动力学变化 切口长度 缓解疼痛 

分 类 号：R687.3[医药卫生—骨科学]