中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
29期
24-26
,共3页
段国庆%张元民%赵晓伟%王雷%隋金颇%张玉革
段國慶%張元民%趙曉偉%王雷%隋金頗%張玉革
단국경%장원민%조효위%왕뢰%수금파%장옥혁
老年人%骨质疏松%髋骨折%外科手术
老年人%骨質疏鬆%髖骨摺%外科手術
노년인%골질소송%관골절%외과수술
Aged%Osteoporosis%Hip fractures%Surgical procedures,operative
目的 探讨70岁以上老年骨质疏松性髋部骨折手术治疗效果,分析老年骨质疏松性髋部骨折的临床特点、围手术期处理及手术方式的选择.方法 对2007年6月至2010年10月收治的70岁以上老年骨质疏松性髋部骨折159例患者进行手术治疗.骨折类型:股骨转子间骨折38例,股骨颈骨折121例.结果 135例患者获得3～43个月随访,其中股骨近端髓内钉固定2例,股骨近端锁定钢板固定13例,动力髋螺钉固定15例,人工双动股骨头置换48例,人工全髋关节置换57例,各种手术方法的术后髋关节Harris评分优良率分别为100.0％(2/2)、76.9％(10/13)、80.0％(12/15)、89.6％( 43/48)、96.5％(55/57).结论 手术是治疗老年骨质疏松性髋部骨折的重要方法,可使患者早期下床活动,减少并发症的发生,提高生存质量,但应做好围手术期的处理,根据骨折类型选择合适的手术方式.
目的 探討70歲以上老年骨質疏鬆性髖部骨摺手術治療效果,分析老年骨質疏鬆性髖部骨摺的臨床特點、圍手術期處理及手術方式的選擇.方法 對2007年6月至2010年10月收治的70歲以上老年骨質疏鬆性髖部骨摺159例患者進行手術治療.骨摺類型:股骨轉子間骨摺38例,股骨頸骨摺121例.結果 135例患者穫得3～43箇月隨訪,其中股骨近耑髓內釘固定2例,股骨近耑鎖定鋼闆固定13例,動力髖螺釘固定15例,人工雙動股骨頭置換48例,人工全髖關節置換57例,各種手術方法的術後髖關節Harris評分優良率分彆為100.0％(2/2)、76.9％(10/13)、80.0％(12/15)、89.6％( 43/48)、96.5％(55/57).結論 手術是治療老年骨質疏鬆性髖部骨摺的重要方法,可使患者早期下床活動,減少併髮癥的髮生,提高生存質量,但應做好圍手術期的處理,根據骨摺類型選擇閤適的手術方式.
목적 탐토70세이상노년골질소송성관부골절수술치료효과,분석노년골질소송성관부골절적림상특점、위수술기처리급수술방식적선택.방법 대2007년6월지2010년10월수치적70세이상노년골질소송성관부골절159례환자진행수술치료.골절류형:고골전자간골절38례,고골경골절121례.결과 135례환자획득3～43개월수방,기중고골근단수내정고정2례,고골근단쇄정강판고정13례,동력관라정고정15례,인공쌍동고골두치환48례,인공전관관절치환57례,각충수술방법적술후관관절Harris평분우량솔분별위100.0％(2/2)、76.9％(10/13)、80.0％(12/15)、89.6％( 43/48)、96.5％(55/57).결론 수술시치료노년골질소송성관부골절적중요방법,가사환자조기하상활동,감소병발증적발생,제고생존질량,단응주호위수술기적처리,근거골절류형선택합괄적수술방식.
Objective To explore.the effect of operative treatment for more than 70-year-old patients with osteoporotic hip fracture,and analyze the clinical feature,perioperative management and choices of operative treatment.Methods One hundred and fifty-nine patients of more than 70-year-old with osteoporotic hip fracture were operated from June 2007 to October 2010.Fracture type:38 cases with intertrochanteric fracture while femoral neck fracture in 121 cases.Results One hundred and thirty-five cases were followed up after operation ranging from 3 to 43 months.There were 2 cases by proximal femur nail internal fixation,13 cases by proximal femur locked plate internal fixation,15 cases by dynamic hip screwinternal fixation,48 cases by bipolar femoral head arthroplasty and 57 cases by total hip arthroplasty.The Harris scores of various surgical method above respectively were 100.0％ (2/2),76.9％ ( 10/13 ),80.0％(12/15),89.6％ (43/48),96.5％ (55/57).Conclusions The operation plays an important role in the treatment of elderly osteoporotic hip fracture,having so many advantages as earlier mobilization,less complications and better life quality.But it is important to pay attention to perioperative management and choose reasonable surgical approach according to classification of fracture.
