解放军医药杂志
解放軍醫藥雜誌
해방군의약잡지
MEDICAL&PHARMACEUTICAL JOURNAL OF CHINESE PEOPLE'S LIBERATION ARMY
2015年
4期
28-31
,共4页
骨水泥半髋置换加钢丝环扎术%股骨骨折%动力髋螺钉%老年人
骨水泥半髖置換加鋼絲環扎術%股骨骨摺%動力髖螺釘%老年人
골수니반관치환가강사배찰술%고골골절%동력관라정%노년인
Bone cement hemiarthroplasty combined with wire cerclage%Femoral fractures%Dynamic hip screw%Aged
目的：探讨骨水泥半髋置换加钢丝环扎术治疗老年粗隆间骨折的临床疗效。方法选取2010年10月—2013年10月收治的粗隆间骨折的老年患者63例,随机分为 DHS 组、PFNA 组、FHR 组,每组21例。 DHS 组采用动力髋螺钉治疗,PFNA 组采用防旋股骨近端髓内钉治疗,FHR 组患者采用骨水泥半髋关节置换结合钢丝环扎术治疗。比较3组手术时间、术中出血量、完全负重时间、骨折愈合时间、Harris 评分[5]以及术后不良反应发生率。结果FHR 组手术时间显著长于 DHS 组及 PFNA 组( P <0．01),FHR 组术中出血量显著多于 DHS 组及 PFNA 组( P <0．01)；FHR 组完全负重时间、骨折愈合时间显著短于 DHS 组及 PFNA 组(P <0．01)；FHR 组术后1、3个月 Harris 评分均显著高于 DHS 组和 PFNA 组(P <0．01)。术后6个月时,3组 Harris 评分比较无统计学差异(P >0.05)。 FHR 组患者术后不良反应发生率显著低于 DHS 组和 PFNA 组(P <0．01)。结论骨水泥半髋置换加钢丝环扎术治疗老年粗隆间骨折耗时较长,术中出血量较多但术后不良反应较少且恢复较快。
目的：探討骨水泥半髖置換加鋼絲環扎術治療老年粗隆間骨摺的臨床療效。方法選取2010年10月—2013年10月收治的粗隆間骨摺的老年患者63例,隨機分為 DHS 組、PFNA 組、FHR 組,每組21例。 DHS 組採用動力髖螺釘治療,PFNA 組採用防鏇股骨近耑髓內釘治療,FHR 組患者採用骨水泥半髖關節置換結閤鋼絲環扎術治療。比較3組手術時間、術中齣血量、完全負重時間、骨摺愈閤時間、Harris 評分[5]以及術後不良反應髮生率。結果FHR 組手術時間顯著長于 DHS 組及 PFNA 組( P <0．01),FHR 組術中齣血量顯著多于 DHS 組及 PFNA 組( P <0．01)；FHR 組完全負重時間、骨摺愈閤時間顯著短于 DHS 組及 PFNA 組(P <0．01)；FHR 組術後1、3箇月 Harris 評分均顯著高于 DHS 組和 PFNA 組(P <0．01)。術後6箇月時,3組 Harris 評分比較無統計學差異(P >0.05)。 FHR 組患者術後不良反應髮生率顯著低于 DHS 組和 PFNA 組(P <0．01)。結論骨水泥半髖置換加鋼絲環扎術治療老年粗隆間骨摺耗時較長,術中齣血量較多但術後不良反應較少且恢複較快。
목적：탐토골수니반관치환가강사배찰술치료노년조륭간골절적림상료효。방법선취2010년10월—2013년10월수치적조륭간골절적노년환자63례,수궤분위 DHS 조、PFNA 조、FHR 조,매조21례。 DHS 조채용동력관라정치료,PFNA 조채용방선고골근단수내정치료,FHR 조환자채용골수니반관관절치환결합강사배찰술치료。비교3조수술시간、술중출혈량、완전부중시간、골절유합시간、Harris 평분[5]이급술후불량반응발생솔。결과FHR 조수술시간현저장우 DHS 조급 PFNA 조( P <0．01),FHR 조술중출혈량현저다우 DHS 조급 PFNA 조( P <0．01)；FHR 조완전부중시간、골절유합시간현저단우 DHS 조급 PFNA 조(P <0．01)；FHR 조술후1、3개월 Harris 평분균현저고우 DHS 조화 PFNA 조(P <0．01)。술후6개월시,3조 Harris 평분비교무통계학차이(P >0.05)。 FHR 조환자술후불량반응발생솔현저저우 DHS 조화 PFNA 조(P <0．01)。결론골수니반관치환가강사배찰술치료노년조륭간골절모시교장,술중출혈량교다단술후불량반응교소차회복교쾌。
Objective To investigate the clinical efficacy of bone cement hemiarthroplasty combined with wire cerclage in treatment of elderly patients with intertrochanteric fracture. Methods A total of 63 elderly patients with in-tertrochanteric fracture during October 2010 and October 2013 were randomly divided into dynamic hip screw group (DHS group, n = 21), proximal femoral nail antirotation group (PFNA group, n = 21) and bone cement hemiarthroplasty com-bined with wire cerclage group (FHR group, n = 21). The operation time, intraoperative bleeding volume, full weight bearing time, fracture healing time, Harris score and postoperative adverse reaction in the three groups were compared. Results In FHR group, the operation time was significantly longer than that of other groups (P < 0. 01). The operative bleeding volume was significantly larger (P < 0. 01); the intraoperative bleeding volume was larger (P < 0. 01); the full weight bearing time and fracture healing time in FHR group were significantly shorter (P < 0. 01); and the Harris scores in 1st and 3rd month after the operation were significantly higher than those in DHS and PFNA groups (P < 0. 01). The differences in Harris score in 6th month after the operation was no statistically significant in the three groups (P > 0. 05). The incidence rate of adverse reaction in FHR group was significantly lower than those in DHS and PFNA groups (P <0. 01). Conclusion Bone cement hemiarthroplasty combined with wire cerclage in treatment of elderly patients with in-tertrochanteric fracture take a longer therapy time with large intraoperative bleeding volume, but with less adverse reaction and quick recovery.
