CAJ | 학술논문

目的：探讨髋关节置换手术治疗高龄不稳定型股骨粗隆间骨折的稳定性及预后。方法选择广东省东莞市凤岗医院骨科收治的70例,年龄70～89岁,股骨粗隆间骨折患者作为观察对象，根据住院号随机将患者分为观察组35例和对照组35例。观察组采用人工全髋关节置换术，对照组则采用股骨近端抗旋髓内钉（PFNA）治疗。评估患者手术治疗情况及随访疗效。结果观察组在手术平均时间以及平均卧床时间方面分别为（85.7±5.7）min、（8.5±4.5）min，显著少于对照组的（92.3±2.1）min（、17.0±4.8）min，差异具无统计学意义，但在平均出血量方面，两组对比差异无统计学意义；随访结果显示，两组患者骨折愈合整体良好，疗效基本相当；观察组生活质量满意度为74.29%，显著高于对照组57.14%，差异具有统计学意义（P＜0.05）。结论髋关节置换手术治疗高龄不稳定型股骨粗隆间骨折患者疗效确切，局部组织修复快，对于体质较差的高龄患者，该术式是提高生存质量的最佳手术方式。
목적：탐토관관절치환수술치료고령불은정형고골조륭간골절적은정성급예후。방법선택광동성동완시봉강의원골과수치적70례,년령70～89세,고골조륭간골절환자작위관찰대상，근거주원호수궤장환자분위관찰조35례화대조조35례。관찰조채용인공전관관절치환술，대조조칙채용고골근단항선수내정（PFNA）치료。평고환자수술치료정황급수방료효。결과관찰조재수술평균시간이급평균와상시간방면분별위（85.7±5.7）min、（8.5±4.5）min，현저소우대조조적（92.3±2.1）min（、17.0±4.8）min，차이구무통계학의의，단재평균출혈량방면，량조대비차이무통계학의의；수방결과현시，량조환자골절유합정체량호，료효기본상당；관찰조생활질량만의도위74.29%，현저고우대조조57.14%，차이구유통계학의의（P＜0.05）。결론관관절치환수술치료고령불은정형고골조륭간골절환자료효학절，국부조직수복쾌，대우체질교차적고령환자，해술식시제고생존질량적최가수술방식。
Objective To explore the hip replacement surgery type treatment of elderly unstable intertrochanteric fracture stability and prognosis. Methods 70 cases admitted in our hospital orthopaedic (aged 70-89 years) patients with intertrochanteric fractures as research object, according to the hospital, patients randomly divided into observation group of 35 cases and control group 35 cases. Observation group with artiifcial total hip replacement, control group adopts the proximal femoral rotation intramedullary nail (PFNA) treatment. Assessment of patients with surgical treatment and follow-up visit. Results Observation group in average operation time and average bed time (85.7 ± 5.7) min, respectively (8.5 ± 4.5) min, signiifcantly less than the control group (92.3 ± 2.1) min and (17.0 ± 4.8) min, statistically signiifcant difference (P<0.05), but in terms of the average blood loss, compared the two groups no signiifcant difference;Follow-up, according to the results of two groups of patients with fracture healing overall is good, the same curative effect;Observation group was 74.29%, the quality of life satisfaction is signiifcantly higher than the control group 57.14%, the difference is statistically signiifcant (P<0.05). Conclusion Hip replacement surgery type unstable intertrochanteric fracture in aged patients curative effect, fast local tissue repair, for older patients constitution is poorer, the operation is the optimal surgical approach to improve the quality of survival.