CAJ | 학술논문

背景：对高龄患者(75岁以上)半髋关节置换后假体周围骨折风险的评估应当从患者术后身体健康情况、生活质量、髋关节功能、骨密度等多种综合性指标来进行动态观察才更准确，而现阶段缺乏相对全面的研究。 　　目的：为临床诊治及预测高龄患者半髋关节置换后假体周围骨折发生风险提供参考。 　　方法：在整理近年来部分国内外学者对髋关节假体周围骨折发生风险因素探究结果的基础上，分析了学者们对相关骨折风险因素的监测方法，同时结合现代检验科学的发展，投入临床加以尝试，总结出更为全面且有一定临床意义的高龄患者半髋关节置换后假体骨折风险因素的评估方法。 　　结果与结论：对于高龄伴有多种内科疾病的股骨颈或转子间骨折患者，半髋关节置换是目前认为最有效的手术方式。高龄患者术后假体周围骨折发生逐渐增多，一旦出现将会给患者精神、经济甚至生命带来极大的打击。因此，早期做出对假体周围骨折风险因素有效的评估，从而选择全面正确的预防策略及治疗方式是预防和挽救这一灾难性后果的必要措施，将会极大改善患者的预后，提高患者的生活质量及存活率。通过当前短期小样本的前瞻性随访研究表明，综合性的动态评估对于高龄老年患者半髋关节置换后骨折风险的评估可能存在一定临床意义，并值得继续探索。
배경：대고령환자(75세이상)반관관절치환후가체주위골절풍험적평고응당종환자술후신체건강정황、생활질량、관관절공능、골밀도등다충종합성지표래진행동태관찰재경준학，이현계단결핍상대전면적연구。 　　목적：위림상진치급예측고령환자반관관절치환후가체주위골절발생풍험제공삼고。 　　방법：재정리근년래부분국내외학자대관관절가체주위골절발생풍험인소탐구결과적기출상，분석료학자문대상관골절풍험인소적감측방법，동시결합현대검험과학적발전，투입림상가이상시，총결출경위전면차유일정림상의의적고령환자반관관절치환후가체골절풍험인소적평고방법。 　　결과여결론：대우고령반유다충내과질병적고골경혹전자간골절환자，반관관절치환시목전인위최유효적수술방식。고령환자술후가체주위골절발생축점증다，일단출현장회급환자정신、경제심지생명대래겁대적타격。인차，조기주출대가체주위골절풍험인소유효적평고，종이선택전면정학적예방책략급치료방식시예방화만구저일재난성후과적필요조시，장회겁대개선환자적예후，제고환자적생활질량급존활솔。통과당전단기소양본적전첨성수방연구표명，종합성적동태평고대우고령노년환자반관관절치환후골절풍험적평고가능존재일정림상의의，병치득계속탐색。
BACKGROUND:For evaluation of risks of periprosthetic fractures in elderly patients aged>75 years old after hemiarthroplasty, we should perform dynamic observation of postoperative physical health status, quality of life, hip function and bone mineral density. Presently, there is lack of general investigation. OBJECTIVE:To provide references for clinical diagnosis and prediction of periprosthetic fractures after hemiarthroplasty in elderly patients. METHODS:On the basis of arranging the exploration results of recent studies on risk factors for periprosthetic fractures of hip joint, we analyzed the monitoring method of scholars concerning fracture-associated risk factors. Simultaneously, in combination of the development of modern inspection sciences, the method was applied in the clinic. Thus, we summarized general evaluation methods with clinical significance for risk factors of prosthesis fracture in elderly patients after hemiarthroplasty. RESULTS AND CONCLUSION:For elderly patients with femoral neck or intertrochanteric fracture combined with various medical il ness, hemiarthroplasty is an effective manner presently. Fractures surrounding the prosthesis in elderly patients postoperatively gradual y increased. Once fracture appeared, it would bring a great attack on patients’ spirit, economy and even life. Therefore, early evaluation on the risk factors for fractures surrounding the prosthesis is a necessary measure for preventing and saving this disastrous consequence by selecting general correct prevention and treatment strategies. This wil greatly improve patients’ prognosis and elevated patient’s quality of life and survival rate. Present short-term smal-sample prospective fol ow-up studies suggested that comprehensive dynamic evaluation possibly has a certain clinical significance for the evaluation of risks of fractures after hemiarthroplasty in elderly patients, and deserves further investigations.