闭合复位小切口PFNA-Ⅱ内固定术与人工股骨头置换术治疗高龄老年人粗隆间骨折的疗效比较

发布时间：2018-05-02 05:46

本文选题：粗隆间骨折 + 老年人　；参考：《苏州大学》2016年硕士论文

【摘要】：【目的】分析75岁以上老年人股骨粗隆间骨折的特点,探讨采用闭合复位小切口PFNA-Ⅱ内固定术与双极人工股骨头置换术治疗疗效,从而选择更适合患者的治疗方案。【方法】收集2014年1月至2015年12月期间治疗的75岁以上不稳定股骨粗隆间骨折患者34例。将患者随机分为A、B两组手术方式,A组采用双极人工股骨头置换术,B组采用PFNA-Ⅱ内固定术。分析比较两组病人在手术切口大小、手术时间、术中出血量、卧床时间、术后Harris评分等方面的差异。【结果】两组相比较,(1)在手术切口大小B优于A;(2)手术时间长短B优于A;(3)术中出血量B优于A;(4)卧床时间长短A优于B;(5)术后末次Harris评分方面A和B差异无统计学意义(p0.05)。【结论】高龄老年人不稳定粗隆间骨折患者多合并骨质疏松,术前基础疾病较多,经全面评估、个体化选择治疗有重要意义。采用闭合复位小切口PFNA-Ⅱ内固定术与双极人工股骨头置换术治疗不稳定型粗隆间骨折都有很好的疗效。双极人工股骨头置换较PFNA-Ⅱ内固定卧床时间短。但PFNA-Ⅱ有着较小的手术切口、较短的手术时间、较少的术中出血量等优势。
[Abstract]:[Objective] to analyze the characteristics of intertrochanteric fracture of the femur in the elderly over 75 years of age, and to explore the therapeutic effect of closed reduction and small incision PFNA- II internal fixation and bipolar artificial femoral head replacement, so as to choose a more suitable treatment for patients. [Methods] the unstable femoral thickness over 75 years of age over the period from January 2014 to December 2015 was collected. 34 cases of intertrochanteric fracture were randomly divided into A, B two groups, group A with bipolar artificial femoral head replacement, group B using PFNA- II internal fixation. The difference between the two groups in the size of the incision, the time of operation, the amount of bleeding, the bed time, and the postoperative Harris score were compared. [results] two groups were compared, (1) The size of the incision B was better than that of A; (2) the length of operation was better than that of A; (3) the amount of bleeding in the operation was better than that of A; (4) the length of the bed time and A were superior to B; (5) there was no significant difference between A and B in the final Harris score after operation (P0.05). [Conclusion] the patients with unstable intertrochanteric fractures in the elderly were more complicated with osteoporosis, and many basic diseases before the operation were comprehensive and were comprehensive. Evaluation, individualized choice of treatment is of great significance. PFNA- II internal fixation with closed reduction and bipolar artificial femoral head replacement for the treatment of unstable intertrochanteric fractures has a good effect. Bipolar artificial femoral head replacement is shorter than that of PFNA- II internal fixation, but PFNA- II has a smaller operative incision and a shorter operative time. Between, less intraoperative bleeding and other advantages.

【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R687.3

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