国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
14期
1715-1718
,共4页
股骨颈骨折%关节置换%老年
股骨頸骨摺%關節置換%老年
고골경골절%관절치환%노년
Femoral neck fractures%Arthroplasty%Elder
目的 探讨老年(>65岁)移位股骨颈骨折人工关节置换术的适应症及术式选择.方法 2003年1月-2008年6月共收治108例移位股骨颈骨折患者,年龄65~90岁,平均76.8岁,全部骨折为Garden Ⅲ或Ⅳ型.全髋关节置换(THA组)62例,人工双极股骨头置换(BH组)46例,随访36~60个月,平均45.6个月.分别比较两组手术时间、术中出血量,术后1年及3年髋关节功能(Harris评分).结果 手术时间:THA组为(97.42±12.27)min,BH组为(71.74±10.86)min,两组比较差异有显著性(P<0.05);术中出血量:THA组为(343.71±64.10)ml,BH组为(306.41±74.33)ml,两组比较差异有显著性(P<0.05);1年Harris评分:THA组为(89.21±5.98)分,BH组为(87.71±5.76)分,两组比较差异上显著性(P>0.05l3年Harris评分:THA组为(87.54±6.42)分,BH组为(82.63±9.39)分两组比较差异有显著性(P<0.05).结论 全髋关节置换较双极置换手术风险大,但是远期效果好.身体状况好、社会活动多,可耐受手术者应首选全髋关节置换;身体状况差,活动少的选择人工双极股骨头置换.
目的 探討老年(>65歲)移位股骨頸骨摺人工關節置換術的適應癥及術式選擇.方法 2003年1月-2008年6月共收治108例移位股骨頸骨摺患者,年齡65~90歲,平均76.8歲,全部骨摺為Garden Ⅲ或Ⅳ型.全髖關節置換(THA組)62例,人工雙極股骨頭置換(BH組)46例,隨訪36~60箇月,平均45.6箇月.分彆比較兩組手術時間、術中齣血量,術後1年及3年髖關節功能(Harris評分).結果 手術時間:THA組為(97.42±12.27)min,BH組為(71.74±10.86)min,兩組比較差異有顯著性(P<0.05);術中齣血量:THA組為(343.71±64.10)ml,BH組為(306.41±74.33)ml,兩組比較差異有顯著性(P<0.05);1年Harris評分:THA組為(89.21±5.98)分,BH組為(87.71±5.76)分,兩組比較差異上顯著性(P>0.05l3年Harris評分:THA組為(87.54±6.42)分,BH組為(82.63±9.39)分兩組比較差異有顯著性(P<0.05).結論 全髖關節置換較雙極置換手術風險大,但是遠期效果好.身體狀況好、社會活動多,可耐受手術者應首選全髖關節置換;身體狀況差,活動少的選擇人工雙極股骨頭置換.
목적 탐토노년(>65세)이위고골경골절인공관절치환술적괄응증급술식선택.방법 2003년1월-2008년6월공수치108례이위고골경골절환자,년령65~90세,평균76.8세,전부골절위Garden Ⅲ혹Ⅳ형.전관관절치환(THA조)62례,인공쌍겁고골두치환(BH조)46례,수방36~60개월,평균45.6개월.분별비교량조수술시간、술중출혈량,술후1년급3년관관절공능(Harris평분).결과 수술시간:THA조위(97.42±12.27)min,BH조위(71.74±10.86)min,량조비교차이유현저성(P<0.05);술중출혈량:THA조위(343.71±64.10)ml,BH조위(306.41±74.33)ml,량조비교차이유현저성(P<0.05);1년Harris평분:THA조위(89.21±5.98)분,BH조위(87.71±5.76)분,량조비교차이상현저성(P>0.05l3년Harris평분:THA조위(87.54±6.42)분,BH조위(82.63±9.39)분량조비교차이유현저성(P<0.05).결론 전관관절치환교쌍겁치환수술풍험대,단시원기효과호.신체상황호、사회활동다,가내수수술자응수선전관관절치환;신체상황차,활동소적선택인공쌍겁고골두치환.
Objective To explore options and proper indication of arthroplasty for treatment of displaced femoral neck fracture in the elderly patients. Methods From January 2003 to June 2008,108 cases with displaced femoral neck fracture were operated by arthroplasty, at average age of 76.8 years (65~90 years). All fractures were Garden's type Ⅲ orⅣ. 62 cases(THA Group)were total hip arthroplasty and 46 cases (BH Group)were bipolar hemiarthroplasty. All cases were followed up for 36-60 months, with an average of 45.6 months. The operation duration, blood loss and hip function (Harris score) postoperative 1 year and 3 years were compared. Results Operative duration: group THA(97.42±12.27), group BH (71.74±10.86);, blood loss: group THA(343.71±64.10), group BH(306.41±74.33); 1 year Harris: group THA(89.21±5.98), group BH(87.71±5.76); 3-year Harris:group THA(87.54±6.42), group BH(82.63±9.39). There were significant differences in operative duration and blood loss between the two groups (P<0.05); there was no significant difference in Harris score of postoperation for 1 year (P>0.05) but there was significant difference(P<0.05) postoperation for 3 years between the two groups. Conclusions There was a higher risk of total hip arthroplasty than hemiarthroplasty, but it has better long term effect. Total hip arthroplasty was a primary choice for healthy and active patients, while hemiarthroplasty was only recommended for patients with poor health and limited activity before fracture.