中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
39期
6339-6344
,共6页
骨科植入物%骨植入物%全髋关节置换%半髋关节置换%股骨近端髓内钉固定%不稳定型股骨转子间骨折%老年患者
骨科植入物%骨植入物%全髖關節置換%半髖關節置換%股骨近耑髓內釘固定%不穩定型股骨轉子間骨摺%老年患者
골과식입물%골식입물%전관관절치환%반관관절치환%고골근단수내정고정%불은정형고골전자간골절%노년환자
Arthroplasty,Replacement,Hip%Femoral Fractures%Fracture Fixation,Intramedulary
背景：目前临床对于老年不稳定型股骨转子间骨折的外科治疗方式较多，如髋关节置换及内固定等，但对各种治疗方式的利弊存在诸多争议。<br> 目的：评估全髋关节置换、半髋关节置换及股骨近端髓内钉固定修复老年不稳定型股骨转子间骨折的临床效果及安全性。<br> 方法：纳入103例老年不稳定型股骨转子间骨折患者，其中男43例，女60例，年龄62-80岁，28例采用全髋关节置换修复，34例采用半髋关节置换修复，41例采用股骨近端髓内钉固定修复，对比3组围手术期并发症发生情况及修复后髋关节功能恢复情况。<br> 结果与结论：①术后内科并发症发生率：股骨近端髓内钉固定组高于全髋关节置换组及半髋关节置换组(P <0.05)，后两组间比较差异无显著性意义。②术后假体并发症发生率：全髋关节置换组低于半髋关节置换组及股骨近端髓内钉固定组(P<0.05)，后两组间比较差异无显著性意义。③髋关节功能恢复：随访12个月，全髋关节置换组、半髋关节置换组优于股骨近端髓内钉固定组(P<0.05)，前两组间比较差异无显著性意义。表明全髋关节置换及半髋关节置换修复老年不稳定型股骨转子间骨折具有较好疗效，可显著恢复髋关节功能，并且全髋关节置换可显著降低并发症发生率。
揹景：目前臨床對于老年不穩定型股骨轉子間骨摺的外科治療方式較多，如髖關節置換及內固定等，但對各種治療方式的利弊存在諸多爭議。<br> 目的：評估全髖關節置換、半髖關節置換及股骨近耑髓內釘固定脩複老年不穩定型股骨轉子間骨摺的臨床效果及安全性。<br> 方法：納入103例老年不穩定型股骨轉子間骨摺患者，其中男43例，女60例，年齡62-80歲，28例採用全髖關節置換脩複，34例採用半髖關節置換脩複，41例採用股骨近耑髓內釘固定脩複，對比3組圍手術期併髮癥髮生情況及脩複後髖關節功能恢複情況。<br> 結果與結論：①術後內科併髮癥髮生率：股骨近耑髓內釘固定組高于全髖關節置換組及半髖關節置換組(P <0.05)，後兩組間比較差異無顯著性意義。②術後假體併髮癥髮生率：全髖關節置換組低于半髖關節置換組及股骨近耑髓內釘固定組(P<0.05)，後兩組間比較差異無顯著性意義。③髖關節功能恢複：隨訪12箇月，全髖關節置換組、半髖關節置換組優于股骨近耑髓內釘固定組(P<0.05)，前兩組間比較差異無顯著性意義。錶明全髖關節置換及半髖關節置換脩複老年不穩定型股骨轉子間骨摺具有較好療效，可顯著恢複髖關節功能，併且全髖關節置換可顯著降低併髮癥髮生率。
배경：목전림상대우노년불은정형고골전자간골절적외과치료방식교다，여관관절치환급내고정등，단대각충치료방식적리폐존재제다쟁의。<br> 목적：평고전관관절치환、반관관절치환급고골근단수내정고정수복노년불은정형고골전자간골절적림상효과급안전성。<br> 방법：납입103례노년불은정형고골전자간골절환자，기중남43례，녀60례，년령62-80세，28례채용전관관절치환수복，34례채용반관관절치환수복，41례채용고골근단수내정고정수복，대비3조위수술기병발증발생정황급수복후관관절공능회복정황。<br> 결과여결론：①술후내과병발증발생솔：고골근단수내정고정조고우전관관절치환조급반관관절치환조(P <0.05)，후량조간비교차이무현저성의의。②술후가체병발증발생솔：전관관절치환조저우반관관절치환조급고골근단수내정고정조(P<0.05)，후량조간비교차이무현저성의의。③관관절공능회복：수방12개월，전관관절치환조、반관관절치환조우우고골근단수내정고정조(P<0.05)，전량조간비교차이무현저성의의。표명전관관절치환급반관관절치환수복노년불은정형고골전자간골절구유교호료효，가현저회복관관절공능，병차전관관절치환가현저강저병발증발생솔。
BACKGROUND:There was a variety of surgery treatment method in senile patients with unstable intertrochanteric fractures, such as hip replacement and internal fixation, but there was a great deal of controversy about advantages and disadvantages of different methods. <br> OBJECTIVE:To evaluate clinical effect and safety of total hip replacement, hemiarthroplasty and proximal femoral nail in senile patients with unstable intertrochanteric fractures. <br> METHODS:103 senile patients with unstable intertrochanteric fractures were selected, including 43 males and 60 females at the age of 62 to 80 years old. There were 28 cases of total hip replacement, 34 cases of hemiarthroplasty and 41 cases of proximal femoral nail. Perioperative complications and recovery of hip function after repair were compared among three groups. <br> RESULTS AND CONCLUSION:(1) The incidence of postoperative complications of internal medicine was higher in the proximal femoral nail group than in the total hip replacement and hemiarthroplasty groups (P < 0.05). No significant difference in the incidence of complications was found between the hemiarthroplasty and total hip replacement groups. (2) The incidence of prosthesis complications was lower in the total hip replacement group than in the hemiarthroplasty and proximal femoral nail groups (P < 0.05). No significant difference in the incidence of prosthesis complications was detectable between the total hip replacement and hemiarthroplasty groups. (3) The recovery of hip function was better in the total hip replacement and hemiarthroplasty groups than in the proximal femoral nail group during 12-month folow-up (P < 0.05), and no significant difference in the recovery of hip function was found between the total hip replacement and hemiarthroplasty groups. These results showed that total hip replacement and hemiarthroplasty had good curative effect on unstable intertrochanteric fractures in senile patients, and could effectively restore the hip function and reduce complications.
