中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2013年
7期
865-868
,共4页
王传文%黄久勤%王红旗%司金春%吴新宝
王傳文%黃久勤%王紅旂%司金春%吳新寶
왕전문%황구근%왕홍기%사금춘%오신보
骨螺丝%骨折固定术,内%髋%股骨颈骨折/并发症%骨质疏松/并发症%关节成形术,置换,髋%老年人
骨螺絲%骨摺固定術,內%髖%股骨頸骨摺/併髮癥%骨質疏鬆/併髮癥%關節成形術,置換,髖%老年人
골라사%골절고정술,내%관%고골경골절/병발증%골질소송/병발증%관절성형술,치환,관%노년인
Bone screws%Fracture fixation,internal%Hip%Femoral neck fractures/complications%Osteoporosis/complications%Arthroplasty,replacement,hip%Aged
目的 对比分析微创动力髋螺钉内固定与全髋关节置换治疗伴骨质疏松的老年股骨转子间骨折的临床疗效.方法 回顾性分析本院2008年7月至2012年6月收治的56例伴骨质疏松的老年股骨转子间骨折患者的临床资料,将28例接受全髋关节置换术的患者作为实验组,28例接受微创动力髋螺钉的患者作为对照组.对比分析两组术中出血及术后引流量、手术时间、内置物松动情况、术后并发症的发生情况及临床疗效.结果 实验组与对照组手术时间、术中出血及术后引流量、术后有限负重时间的差异比较有统计学意义[(96.37±20.42) min,(529.85±73.82)ml,(7.46±1.23)d vs(66.84±18.63)min,(152.79±37.35)ml,(14.32±2.62)d,t=5.653,24.117,12.542,P <0.01],两组FRS评分与Harris评分差异无统计学意义[(27.75±3.59)分,(89.84±4.17)分vs(26.41±3.16)分,(88.68±3.92)分,P>0.05];对照组高危骨质疏松组内置物松动率要明显高于低危组(66.7%vs 18.8%,x2=4.745,P<0.05),实验组高危骨质疏松组与低危组内置物松动情况比较差异无统计学意义(11.1%vs 10.0%,P>0.05);实验组的并发症发生率要显著低于对照组(3.6%vs 28.6%,x2=4.766,P<0.05).结论 对于合并骨质疏松的老年股骨转子间骨折,应根据患者的个体情况及骨质疏松的程度选择手术方式,术后抗骨质疏松治疗也应得到重视.
目的 對比分析微創動力髖螺釘內固定與全髖關節置換治療伴骨質疏鬆的老年股骨轉子間骨摺的臨床療效.方法 迴顧性分析本院2008年7月至2012年6月收治的56例伴骨質疏鬆的老年股骨轉子間骨摺患者的臨床資料,將28例接受全髖關節置換術的患者作為實驗組,28例接受微創動力髖螺釘的患者作為對照組.對比分析兩組術中齣血及術後引流量、手術時間、內置物鬆動情況、術後併髮癥的髮生情況及臨床療效.結果 實驗組與對照組手術時間、術中齣血及術後引流量、術後有限負重時間的差異比較有統計學意義[(96.37±20.42) min,(529.85±73.82)ml,(7.46±1.23)d vs(66.84±18.63)min,(152.79±37.35)ml,(14.32±2.62)d,t=5.653,24.117,12.542,P <0.01],兩組FRS評分與Harris評分差異無統計學意義[(27.75±3.59)分,(89.84±4.17)分vs(26.41±3.16)分,(88.68±3.92)分,P>0.05];對照組高危骨質疏鬆組內置物鬆動率要明顯高于低危組(66.7%vs 18.8%,x2=4.745,P<0.05),實驗組高危骨質疏鬆組與低危組內置物鬆動情況比較差異無統計學意義(11.1%vs 10.0%,P>0.05);實驗組的併髮癥髮生率要顯著低于對照組(3.6%vs 28.6%,x2=4.766,P<0.05).結論 對于閤併骨質疏鬆的老年股骨轉子間骨摺,應根據患者的箇體情況及骨質疏鬆的程度選擇手術方式,術後抗骨質疏鬆治療也應得到重視.
목적 대비분석미창동력관라정내고정여전관관절치환치료반골질소송적노년고골전자간골절적림상료효.방법 회고성분석본원2008년7월지2012년6월수치적56례반골질소송적노년고골전자간골절환자적림상자료,장28례접수전관관절치환술적환자작위실험조,28례접수미창동력관라정적환자작위대조조.대비분석량조술중출혈급술후인류량、수술시간、내치물송동정황、술후병발증적발생정황급림상료효.결과 실험조여대조조수술시간、술중출혈급술후인류량、술후유한부중시간적차이비교유통계학의의[(96.37±20.42) min,(529.85±73.82)ml,(7.46±1.23)d vs(66.84±18.63)min,(152.79±37.35)ml,(14.32±2.62)d,t=5.653,24.117,12.542,P <0.01],량조FRS평분여Harris평분차이무통계학의의[(27.75±3.59)분,(89.84±4.17)분vs(26.41±3.16)분,(88.68±3.92)분,P>0.05];대조조고위골질소송조내치물송동솔요명현고우저위조(66.7%vs 18.8%,x2=4.745,P<0.05),실험조고위골질소송조여저위조내치물송동정황비교차이무통계학의의(11.1%vs 10.0%,P>0.05);실험조적병발증발생솔요현저저우대조조(3.6%vs 28.6%,x2=4.766,P<0.05).결론 대우합병골질소송적노년고골전자간골절,응근거환자적개체정황급골질소송적정도선택수술방식,술후항골질소송치료야응득도중시.
Objective To compare the outcomes of total hip replacement and minimally invasive dynamic hip screw in treating osteoporotic femoral intertrochanterie fractures.Methods Retrospectively analyze the clinical data of 56 patients with osteoporotic femoral intertrochanteric fractures who came to our hospital from July,2008-June,2012.Twenty eight cases who accepted minimally invasive dynamic hip screw were divided into the control group while 28 cases who accepted total hip replacement were divided into the experimental group.The blood loss and postoperative drainage,operative time,situation of implant loosening,the occurrence of postoperative complications and the clinical curative effect were compared between two groups.Results The differences in operative time,blood loss,and postoperative drainage flow,limited weight-bearing after operation was statistically significant between two group[(96.37 ± 20.42)min,(529.85±73.82) ml,(7.46±1.23) dvs (66.84±18.63)min,(152.79±37.35) ml,(14.32±2.62)d,t=5.653,24.117,12.542,P<0.05].The differences in FRS score and Harris score between twogroups was not statistically significant [(27.75±3.59),(89.84±4.17) vs (26.41±3.16),(88.68±3.92),P> 0.05].The incidence in internal fixation loosening varied significantly with different degree of osteoporosis in the control group (66.7%vs18.8%,x2 =4.745,P < 0.05) but not in the experimental group (11.1% vs 10.0%,P>0.05).Complication rate of the experimental group was significantly lower than the control group (3.6%vs 28.6%,x2 =4.766,P < 0.05).Conclusions For the elder patients with osteoporotic femoral intertrochanteric fractures,the selection of surgical approach should be based on the patient's individual circumstances and the degree of osteoporosis.In the same time,attention should be paid to anti-osteoporosis therapy after operation.