CAJ | 학술논문

目的评估以人工股骨头置换术为基础,多学科综合治疗合并严重基础疾病的老年陈旧性股骨颈骨折的效果和安全性. 方法 36例老年陈旧性股骨颈骨折患者,平均年龄78.2岁,平均受伤时间13.7个月,均合并1种及以上较严重的基础疾病.所有患者均接受人工股骨头置换术.回顾性分析围术期并发症,评估术后6个月髋关节功能. 结果 1例术后因严重肺部感染死亡,余35例发生电解质紊乱16例,低血压7例,心律失常4例,急性心功能衰竭2例,急性肾损伤1例,经正规治疗后均好转,安全度过围术期.髋关节Harris评分由术前的(22.0±6.8)分提高到术后6个月的(69.2±10.8)分(P＜0.01). 结论以人工股骨头置换术为基础的综合治疗,是合并有严重基础疾病的老年陈旧性股骨颈骨折的有效处理手段.
목적 평고이인공고골두치환술위기출,다학과종합치료합병엄중기출질병적노년진구성고골경골절적효과화안전성. 방법 36례노년진구성고골경골절환자,평균년령78.2세,평균수상시간13.7개월,균합병1충급이상교엄중적기출질병.소유환자균접수인공고골두치환술.회고성분석위술기병발증,평고술후6개월관관절공능. 결과 1례술후인엄중폐부감염사망,여35례발생전해질문란16례,저혈압7례,심률실상4례,급성심공능쇠갈2례,급성신손상1례,경정규치료후균호전,안전도과위술기.관관절Harris평분유술전적(22.0±6.8)분제고도술후6개월적(69.2±10.8)분(P＜0.01). 결론 이인공고골두치환술위기출적종합치료,시합병유엄중기출질병적노년진구성고골경골절적유효처리수단.
Objective To investigate the effect and safety of comprehensive therapy based on femoral head arthroplasty in treating old femoral neck fracture in the elderly complicated with other severe basic medical conditions.Methods Thirty-six elderly patients with old femoral neck fracture were treated with femoral head arthroplasty.Mean age of the patients was 78.2 years, and mean duration since injury was 13.7 months.All the patients had at least one severe basic medical problem.Perioperative complications were retrospectively analyzed, and function of hip joint was evaluated 6 months after operation.Results One patient died because of severe pulmonary infection, while 16 electrolyte imbalance, 7 hypotension, 4 arrhythmia, 2 acute heart failure and 1 acute kidney injury were cured in the rest 35 patients.Harris hip score of the 35 patients increased from (22.0 ± 6.8) points pre-operatively to (69.2 ± 10.8) points 6 months post-operatively (P ＜ 0.01).Conclusions Comprehensive therapy based on femoral head arthroplasty is effective for old femoral neck fracture in the elderly suffering severe underlying diseases.Early treatment, perfect pre-operative preparation, correct manipulation and appropriate perioperative management play important roles.