中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
11期
17-19
,共3页
王春利%陶树清%曹德宇%信鑫鑫%林源
王春利%陶樹清%曹德宇%信鑫鑫%林源
왕춘리%도수청%조덕우%신흠흠%림원
股骨颈骨折%老年人%关节成形术,置换,髋%骨折,内固定术
股骨頸骨摺%老年人%關節成形術,置換,髖%骨摺,內固定術
고골경골절%노년인%관절성형술,치환,관%골절,내고정술
Femoral neck fractures%Aged%Arthroplasty,replacement,hip%Fracture fixation,internal
目的 比较老年移位型股骨颈骨折Ⅰ期行人工全髋关节置换(THR)与内固定失效后再行THR的疗效,探讨老年移位型股骨颈骨折的治疗方法.方法 选择2006年1月至2012年12月因内固定失效后行THR的老年移位型股骨颈骨折患者22例作为观察组,另选择同期因移位型股骨颈骨折Ⅰ期行THR的老年移位型股骨颈骨折患者30例作为对照组,观察比较两组手术时间、术中出血量、Harris评分及KPS生活质量评分.结果 两组患者均成功获得随访,两组各有1例患者死亡,两组患者均未发生关节感染、翻修等严重并发症.观察组手术时间(114.82±32.13) min,明显长于对照组的(90.63±16.24) min,术中出血量(551.73±241.62) ml,明显多于对照组的(314.46±156.72) ml,差异均有统计学意义(P＜0.05);两组术后Harris评分、KPS生活质量评分比较差异无统计学意义(P＞ 0.05).结论 老年移位型股骨颈骨折Ⅰ期行THR手术风险低于内固定失效后再行THR,但在术后髋关节功能恢复及提高患者生活质量方面两种方法相似.
目的 比較老年移位型股骨頸骨摺Ⅰ期行人工全髖關節置換(THR)與內固定失效後再行THR的療效,探討老年移位型股骨頸骨摺的治療方法.方法 選擇2006年1月至2012年12月因內固定失效後行THR的老年移位型股骨頸骨摺患者22例作為觀察組,另選擇同期因移位型股骨頸骨摺Ⅰ期行THR的老年移位型股骨頸骨摺患者30例作為對照組,觀察比較兩組手術時間、術中齣血量、Harris評分及KPS生活質量評分.結果 兩組患者均成功穫得隨訪,兩組各有1例患者死亡,兩組患者均未髮生關節感染、翻脩等嚴重併髮癥.觀察組手術時間(114.82±32.13) min,明顯長于對照組的(90.63±16.24) min,術中齣血量(551.73±241.62) ml,明顯多于對照組的(314.46±156.72) ml,差異均有統計學意義(P＜0.05);兩組術後Harris評分、KPS生活質量評分比較差異無統計學意義(P＞ 0.05).結論 老年移位型股骨頸骨摺Ⅰ期行THR手術風險低于內固定失效後再行THR,但在術後髖關節功能恢複及提高患者生活質量方麵兩種方法相似.
목적 비교노년이위형고골경골절Ⅰ기행인공전관관절치환(THR)여내고정실효후재행THR적료효,탐토노년이위형고골경골절적치료방법.방법 선택2006년1월지2012년12월인내고정실효후행THR적노년이위형고골경골절환자22례작위관찰조,령선택동기인이위형고골경골절Ⅰ기행THR적노년이위형고골경골절환자30례작위대조조,관찰비교량조수술시간、술중출혈량、Harris평분급KPS생활질량평분.결과 량조환자균성공획득수방,량조각유1례환자사망,량조환자균미발생관절감염、번수등엄중병발증.관찰조수술시간(114.82±32.13) min,명현장우대조조적(90.63±16.24) min,술중출혈량(551.73±241.62) ml,명현다우대조조적(314.46±156.72) ml,차이균유통계학의의(P＜0.05);량조술후Harris평분、KPS생활질량평분비교차이무통계학의의(P＞ 0.05).결론 노년이위형고골경골절Ⅰ기행THR수술풍험저우내고정실효후재행THR,단재술후관관절공능회복급제고환자생활질량방면량충방법상사.
Objective To compare the clinical effect of the primary total hip replacement (THR)and the secondary THR after failed internal fixation in elderly patients with displaced femoral neck fracture,so as to investigate the optimal treatment for displaced femoral neck fractures in elderly patients.Methods From January 2006 to December 2012,22 patients treated with a secondary THR after failed internal fixation were chosen as the observation group and 30 patients treated with a primary THR were chosen as the control group,the operation time,blood loss,postoperative Harris scores for hip joint and health-related quality of life (~ index score) were observed and analyzed in two groups.Results Both of the groups were followed up successfully and each of the groups had 1 patient died.There were no joint infection,re-operations and any other complications in both groups.The operation time in observation group was longer than that in control group [(114.82 ±32.13) min vs.(90.63 ± 16.24) min],blood loss was more than that in control group [(551.73 ± 241.62) ml vs.(314.46:± 156.72) ml],there was significant difference (P ＜ 0.05).But the Harris score and KPS index score between two groups had no significant differences (P ＞ 0.05).Conclusion The primary THR in elderly patients with displaced femoral neck fracture has lower risk in operation tocompare with the secondary THR after failed internal fixation,but the two ways are similar in the hip joint function recovery and improve patients quality of life.
