中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
5期
515-518
,共4页
唐谨%郭卫春%余铃%赵胜豪
唐謹%郭衛春%餘鈴%趙勝豪
당근%곽위춘%여령%조성호
股骨颈骨折%老年人%空心加压螺钉固定%人工股骨头置换术%人工髋关节置换
股骨頸骨摺%老年人%空心加壓螺釘固定%人工股骨頭置換術%人工髖關節置換
고골경골절%노년인%공심가압라정고정%인공고골두치환술%인공관관절치환
Femoral neck fracture%Elderl%Compression hollow screw fixation%Artificial femoral head replacement%Total hip replacement
目的 比较加压空心钉、人工股骨头置换以及人工髋关节置换三种手术方法在治疗老年股骨颈骨折的效果.方法 2007年8月至2009年4月,对152例老年股骨颈骨折患者采用空心加压螺钉内固定54例(空心钉组);人工股骨头置换术48例(人工股骨头组);人工髋关节置换术50例(人工骨髋关节组).分别比较3组患者平均手术时间、平均手术出血量、平均住院时间、平均术后卧床时间;术后功能根据Harris评分法进行评估.结果 3组患者Harris评分中,空心钉组优21例,良23例,平均(80.52±2.70)分;人工股骨头组优26例,良14例,平均(86.57±1.90)分;人工髋关节组优42例,良3例,平均(96.04±2.10)分,人工髋关节组疗效明显优于另2组(H=0.589,F=12.151,P均＜0.05).术后并发症发生率,空心钉组25.93%(14/54),人工股骨头组18.75%(9/48),人工髋关节组4.00%(2/50),人工髋关节组最低,较其他2组差异有统计学意义(H=1.291,P＜0.05).结论 人工髋关节置换更好的恢复功能、提高患者生活质量,术后并发症少,但术中创伤大、出血量大;在治疗老年股骨颈骨折时应综合考虑患者的年龄、身体状况、骨折移位程度等因素,以选择合适的手术方式.
目的 比較加壓空心釘、人工股骨頭置換以及人工髖關節置換三種手術方法在治療老年股骨頸骨摺的效果.方法 2007年8月至2009年4月,對152例老年股骨頸骨摺患者採用空心加壓螺釘內固定54例(空心釘組);人工股骨頭置換術48例(人工股骨頭組);人工髖關節置換術50例(人工骨髖關節組).分彆比較3組患者平均手術時間、平均手術齣血量、平均住院時間、平均術後臥床時間;術後功能根據Harris評分法進行評估.結果 3組患者Harris評分中,空心釘組優21例,良23例,平均(80.52±2.70)分;人工股骨頭組優26例,良14例,平均(86.57±1.90)分;人工髖關節組優42例,良3例,平均(96.04±2.10)分,人工髖關節組療效明顯優于另2組(H=0.589,F=12.151,P均＜0.05).術後併髮癥髮生率,空心釘組25.93%(14/54),人工股骨頭組18.75%(9/48),人工髖關節組4.00%(2/50),人工髖關節組最低,較其他2組差異有統計學意義(H=1.291,P＜0.05).結論 人工髖關節置換更好的恢複功能、提高患者生活質量,術後併髮癥少,但術中創傷大、齣血量大;在治療老年股骨頸骨摺時應綜閤攷慮患者的年齡、身體狀況、骨摺移位程度等因素,以選擇閤適的手術方式.
목적 비교가압공심정、인공고골두치환이급인공관관절치환삼충수술방법재치료노년고골경골절적효과.방법 2007년8월지2009년4월,대152례노년고골경골절환자채용공심가압라정내고정54례(공심정조);인공고골두치환술48례(인공고골두조);인공관관절치환술50례(인공골관관절조).분별비교3조환자평균수술시간、평균수술출혈량、평균주원시간、평균술후와상시간;술후공능근거Harris평분법진행평고.결과 3조환자Harris평분중,공심정조우21례,량23례,평균(80.52±2.70)분;인공고골두조우26례,량14례,평균(86.57±1.90)분;인공관관절조우42례,량3례,평균(96.04±2.10)분,인공관관절조료효명현우우령2조(H=0.589,F=12.151,P균＜0.05).술후병발증발생솔,공심정조25.93%(14/54),인공고골두조18.75%(9/48),인공관관절조4.00%(2/50),인공관관절조최저,교기타2조차이유통계학의의(H=1.291,P＜0.05).결론 인공관관절치환경호적회복공능、제고환자생활질량,술후병발증소,단술중창상대、출혈량대;재치료노년고골경골절시응종합고필환자적년령、신체상황、골절이위정도등인소,이선택합괄적수술방식.
Objective To compare the effect of compression hollow screw fixation,artificial femoral head replacement and total hip replacement in the elderly.Methods From August 2007 to April 2009,152 cases of femoral neck fracture in the elderly were divided into three groups: compression hollow screw fixation group(54 patients,24 males,with an average age of 59.8±5.3 years);artificial femoral head replacement group(48 patients,16 males,with an average age of 65.3±6.7 years);and total hip replacement group(50 patients,18 males,with an average age of 77.3±6.5 years).The evaluation indicators,including the average sugical time,the average amount of bleeding,the average length of stay and the average postopererative bed time,were compared respectively among the three groups.The postoperative evaluation was made according to Harris Score.Results Harris score in the three groups were 21 excellent and 23 good in the compression hollow screw fixation group,with an average score of 80.52±2.70;26 excellent and 14 good in the artificial femoral head replacement group,with an average score of 86.57±1.90;and 42 excellent and 3 good in the total hip replacement group,with an average score of 96.04±2.10.The total hip replacement group was significantly better than the other two groups(H=0.589,F=12.151,Ps＜0.05).The rate of postoperative complications were 25.93%(14/54) in the compression hollow screw fixation group,18.75%(9/48) in the artificial femoral head replacement group and 4.00%(2/50) in the total hip replacement group(H=1.291,P＜0.05).Conclusion Compared among the three surgery,total hip replacement could resume function and improve the quality of life better,with lower rate of complications.However,the surgical injury and the amount of bleeding were largest.Therefore,we suggest selecting appropriate surgery with considering the patient′s age,physical condition,displacement degree of the fracture,et al.in old femoral neck fractures patients.
