老年人转子间骨折亚急诊手术治疗的临床研究

发布时间：2018-06-19 04:29

本文选题：亚急诊手术 + 转子间骨折　；参考：《河南中医学院》2015年硕士论文

【摘要】：目的:股骨转子间骨折是临床常见的髋部骨折,尤其好发于老年人,随着我国逐渐步入老龄化社会,也会有越来越多的转子间骨折患者。老年人转子间骨折后的致残率和死亡率较高,不仅严重影响患者的生活质量,也威胁患者的生命。老年人多合并有内科疾病,且年龄偏大,骨折入院后,出于手术安全性和家属意愿等诸多方面的原因,急诊手术难以施行,老年人又不宜长时间卧床,因此我们选择手术风险相对较低,同时又可以缩短术前等待时间的亚急诊手术来治疗这类特殊的人群,并探讨它的临床效果和可行性。方法:选取2014年4月至2014年11月我院收治的符合研究标准的47例65岁以上高龄转子间骨折患者的临床资料。根据受伤至接受手术的时间为标准将患者分为2组,其中亚急诊手术组(即伤后24h内接受手术)有20例,择期手术组(受伤24h后接受手术)有27例,所有患者均采用股骨近端防旋髓内钉(PFNA)方法进行微创固定。两组从住院期间的并发症、髋关节功能、骨折愈合时间、住院时间进行统计比较。结果:47例患者全部获得随访,时间4~7个月,平均5.4个月。亚急诊手术组患者住院期间并发症低于择期手术组,两组间差异具有统计学意义(P0.05);两组骨折愈合时间分别为(13.1±1.8、13.6±1.2)周,差异无统计学意义(P0.05);末次随访时,亚急诊手术组髋关节功能平均(82.7±5.8)分,择期手术组平均(81.4±5.9)分,两组间差异无统计学意义(P0.05);亚急诊手术组和择期手术组的住院时间分别为(12.1±1.6)d和(16.1±1.8)d,两组间差异具有统计学意义(P0.05)。结论:通过伤后24h内的亚急诊手术治疗老年转子间骨折,不仅够减少术后并发症的发生,而且能减少住院的时间。
[Abstract]:Objective: intertrochanteric fracture of femur is a common hip fracture, especially in the elderly. With the aging society, there will be more and more intertrochanteric fractures in China. The high rate of disability and mortality after intertrochanteric fracture not only seriously affects the quality of life of the patients, but also threatens the life of the patients. Most of the elderly are complicated with internal medical diseases, and they are too old. After the fracture is admitted to hospital, the emergency operation is difficult to carry out and the elderly should not stay in bed for a long time because of the safety of the operation and the will of the family. Therefore, we choose sub-emergency surgery which is relatively low in risk and can shorten the waiting time before operation to treat this kind of special population, and to explore its clinical effect and feasibility. Methods: the clinical data of 47 patients with intertrochanteric fracture over 65 years old admitted to our hospital from April 2014 to November 2014 were selected. The patients were divided into two groups according to the time from injury to operation. There were 20 cases in the sub-emergency operation group (within 24 hours after injury) and 27 cases in the selective operation group (24 hours after injury). All patients underwent minimally invasive fixation with PFNAs at the proximal end of the femur. The complications, hip function, fracture healing time and hospitalization time were compared between the two groups. Results all 47 cases were followed up for 4 ~ 7 months (mean 5.4 months). The complications in the subemergency operation group were lower than those in the elective operation group, the difference was statistically significant (P 0.05), the fracture healing time of the two groups was 13.1 卤1.8 卤13.6 卤1.2 weeks, and the difference was not statistically significant (P 0.05). The average score of hip joint function was 82.7 卤5.8 in the sub-emergency operation group and 81.4 卤5.9 in the elective operation group. There was no significant difference between the two groups (P 0.05), and the hospitalization time of the sub-emergency operation group and the elective operation group were 12.1 卤1.6 days and 16.1 卤1.8 days, respectively. The difference between the two groups was statistically significant (P 0.05). Conclusion: the treatment of intertrochanteric fracture in the elderly by subemergency operation within 24 hours after injury can not only reduce the incidence of postoperative complications, but also reduce the length of hospitalization.
【学位授予单位】：河南中医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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