中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2015年
6期
531-535
,共5页
张舜%陈坤峰%张传林%段广超%南运东
張舜%陳坤峰%張傳林%段廣超%南運東
장순%진곤봉%장전림%단엄초%남운동
股骨骨折%关节成形术,置换%老年人
股骨骨摺%關節成形術,置換%老年人
고골골절%관절성형술,치환%노년인
Femoral fractures%Arthroplasty,replacement%Aged
目的 探讨双动水泥型人工股骨头置换术治疗合并心肺脑疾病高龄股骨转子间骨折患者的临床效果. 方法 2005年1月-2013年10月收治75 ～86岁患心肺脑等疾病股骨转子间骨折患者23例,骨折按Evans分型:Ⅰ型3例,Ⅱ型9例,Ⅲa型5例,Ⅲb型2例,Ⅳ型3例,逆转子间型骨折1例.采用双动水泥型人工股骨头置换(置换组);另选取同期在年龄、合并疾病相当的股骨近端锁定钢板内固定23例作为对照组.比较两组手术时间、术中出血量、术后引流量、引流管拔除时间、抗生素应用量、围术期并发症、卧床并发症、骨折内固定并发症、Harris评分.结果 置换组与对照组比较,在平均手术时间(52.7 min∶52.0 min)、平均术中出血量(160.9 ml∶156.5 ml)、平均术后引流量(162.2 ml∶158.3 ml)、平均引流管拔除时间(69.9 h∶68.9 h)、平均Harris评分(73.7分∶74.2分)等方面差异均无统计学意义(P＞0.05).两组均预防应用抗生素5d.在平均下床时间(8.1 d∶109.3 d)、围术期并发症发生率(19％∶59％)、卧床并发症发生率(0∶36％)、内固定并发症发生率(0∶18％)方面置换组均明显低于内固定组(P＜0.05).结论 双动骨水泥型人工股骨头置换术治疗合并心肺脑等疾病高龄患者股骨转子间骨折可有效预防骨折内固定、围术期及卧床并发症,提高患者生存质量.
目的 探討雙動水泥型人工股骨頭置換術治療閤併心肺腦疾病高齡股骨轉子間骨摺患者的臨床效果. 方法 2005年1月-2013年10月收治75 ～86歲患心肺腦等疾病股骨轉子間骨摺患者23例,骨摺按Evans分型:Ⅰ型3例,Ⅱ型9例,Ⅲa型5例,Ⅲb型2例,Ⅳ型3例,逆轉子間型骨摺1例.採用雙動水泥型人工股骨頭置換(置換組);另選取同期在年齡、閤併疾病相噹的股骨近耑鎖定鋼闆內固定23例作為對照組.比較兩組手術時間、術中齣血量、術後引流量、引流管拔除時間、抗生素應用量、圍術期併髮癥、臥床併髮癥、骨摺內固定併髮癥、Harris評分.結果 置換組與對照組比較,在平均手術時間(52.7 min∶52.0 min)、平均術中齣血量(160.9 ml∶156.5 ml)、平均術後引流量(162.2 ml∶158.3 ml)、平均引流管拔除時間(69.9 h∶68.9 h)、平均Harris評分(73.7分∶74.2分)等方麵差異均無統計學意義(P＞0.05).兩組均預防應用抗生素5d.在平均下床時間(8.1 d∶109.3 d)、圍術期併髮癥髮生率(19％∶59％)、臥床併髮癥髮生率(0∶36％)、內固定併髮癥髮生率(0∶18％)方麵置換組均明顯低于內固定組(P＜0.05).結論 雙動骨水泥型人工股骨頭置換術治療閤併心肺腦等疾病高齡患者股骨轉子間骨摺可有效預防骨摺內固定、圍術期及臥床併髮癥,提高患者生存質量.
목적 탐토쌍동수니형인공고골두치환술치료합병심폐뇌질병고령고골전자간골절환자적림상효과. 방법 2005년1월-2013년10월수치75 ～86세환심폐뇌등질병고골전자간골절환자23례,골절안Evans분형:Ⅰ형3례,Ⅱ형9례,Ⅲa형5례,Ⅲb형2례,Ⅳ형3례,역전자간형골절1례.채용쌍동수니형인공고골두치환(치환조);령선취동기재년령、합병질병상당적고골근단쇄정강판내고정23례작위대조조.비교량조수술시간、술중출혈량、술후인류량、인류관발제시간、항생소응용량、위술기병발증、와상병발증、골절내고정병발증、Harris평분.결과 치환조여대조조비교,재평균수술시간(52.7 min∶52.0 min)、평균술중출혈량(160.9 ml∶156.5 ml)、평균술후인류량(162.2 ml∶158.3 ml)、평균인류관발제시간(69.9 h∶68.9 h)、평균Harris평분(73.7분∶74.2분)등방면차이균무통계학의의(P＞0.05).량조균예방응용항생소5d.재평균하상시간(8.1 d∶109.3 d)、위술기병발증발생솔(19％∶59％)、와상병발증발생솔(0∶36％)、내고정병발증발생솔(0∶18％)방면치환조균명현저우내고정조(P＜0.05).결론 쌍동골수니형인공고골두치환술치료합병심폐뇌등질병고령환자고골전자간골절가유효예방골절내고정、위술기급와상병발증,제고환자생존질량.
Objective To evaluate the clinical outcomes of cemented bipolar femoral head arthroplasty in treatment of intertrochanteric fractures in elderly patients combined with heart,lung,brain and other diseases.Methods The study comprised 23 cases,aged 75-86 years old,treated with cemented bipolar artificial femoral head arthroplasty between January 2005 and October 2013 (replacement group).Evans' classification of the fracture was type Ⅰ in 3 cases,type Ⅱ in 9,type Ⅲ a in 5,type Ⅲ b in 2,type Ⅳ in 3 and reverse intertrochanteric fracture in 1.Additionally,23 cases with the similar physical condition treated with anatomical locking plates were chosen as controls.For comparisons between groups,operation time,amount of bleeding,drainage volume,mean time to extract drainage tub,antibiotics dosage,perioperative complications,complications of lying in bed,fracture complications and Harris score were measured.Results There were no significant differences between replacement and control groups with respect to operation time (52.7 minutes vs 52.0 minutes),amount of bleeding (160.9 ml vs 156.5 ml),drainage volume (162.2 ml vs 158.3 ml),Harris score (73.7 points vs 74.2 points),time to extract drainage tub (69.9 hours vs 68.9 hours) (P ＞ 0.05).Both groups had 5 days of preventive antibiotic usage.Better results were observed in replacement group than in control group concerning mean time of ambulation (8.1 days vs 109.3 days),rate of perioperative complications (19％ vs 59％),rate of bed rest complications (0 vs 36％) and rate of internal fixation complications (0 vs 18％) (P ＜ 0.05).Conclusion Cemented bipolar femoral head arthroplasty is effective to prevent the complications of internal fixation,bed rest as well as perioperation and improve the quality of life during the treatment of intertrochanteric fracture in elder patients with heart,lung,brain and other diseases.
