高龄股骨转子间骨折保守治疗与四种手术治疗比较

发布时间：2019-01-10 09:32

【摘要】：[目的]比较保守治疗、锁定板、PFNA、半髋关节置换和全髋关节置换治疗高龄股骨转子间骨折的临床效果。[方法]收集2014年2月~2016年2月在本院治疗且符合标准的195例高龄转子间骨折患者的临床资料,按照随机数字表法分为5组:保守治疗组(甲组)、锁定板组(乙组)、PFNA组(丙组)、半髋关节置换组(丁组)和全髋关节置换组(戊组),比较五组患者总住院时间、手术时间、术中出血量、术后髋关节Harris功能评分、术后总并发症率。[结果]甲组的总住院时间高于其他四组,差异有统计学意义(P0.05)。乙组和丙组患者总住院时间高于丁组和戊组(P0.05),乙组患者手术时间、术中出血量显著高于其余三组(P0.05);丁组患者手术时间显著短于其余三组(P0.05),丙组和丁组术中出血量显著低于其余两组,差异均有统计学意义(P0.05);术后3、6、12个月丁组和戊组患者髋关节Harris功能评分显著高于其余三组(P0.05),甲组患者髋关节Harris功能评分显著低于其余四组(P0.05);甲组、乙组、丙组、丁组、戊组患者总并发症发生率分别为41.67%、24.39%、23.26%、21.05%、21.62%,其中甲组总并发症率显著高于其余四组,差异均有统计学意义(P0.05)。[结论]对高龄股骨转子间骨折采用保守治疗效果最差。选用内固定或关节置换治疗老年股骨转子间骨折均能获得较好临床疗效,但关节置换可早期下床及减少早期并发症的发生率。
[Abstract]:[objective] to compare the clinical effects of conservative treatment, locking plate, PFNA, hemihip replacement and total hip replacement in the treatment of intertrochanteric fracture of femur in elderly patients. [methods] the clinical data of 195 elderly patients with intertrochanteric fracture treated in our hospital from February 2014 to February 2016 were collected and divided into five groups according to random number table: conservative treatment group (group A), locking plate group (group B). PFNA group (group C), hemihip replacement group (group D) and total hip replacement group (group E) were compared. The total hospital stay, operative time, intraoperative bleeding volume, hip Harris score and total postoperative complications were compared among the five groups. [results] the total hospitalization time of group A was higher than that of other four groups, the difference was statistically significant (P0.05). The total hospitalization time of group B and group C was higher than that of group D and group E (P0.05). The time of operation and the amount of intraoperative bleeding in group B were significantly higher than those in the other three groups (P0.05). The operative time in group D was significantly shorter than that in the other three groups (P0.05). The amount of intraoperative bleeding in group C and group D was significantly lower than that in the other two groups (P0.05). The Harris score of hip joint in group D and E was significantly higher than that in the other three groups (P0.05), and the score of Harris in group A was significantly lower than that in the other four groups (P0.05). The incidence of total complications in group A, group B, group C, group D and group E were 41.67 and 24.3923.26, respectively. The total complication rate of group A was significantly higher than that of the other four groups, and the total complication rate of group A was significantly higher than that of the other four groups. The difference was statistically significant (P0.05). [conclusion] the conservative treatment of intertrochanteric fracture in the elderly is the worst. The treatment of intertrochanteric fracture of femur with internal fixation or arthroplasty can obtain better clinical effect, but joint replacement can reduce the incidence of early complications and get out of bed early.
【作者单位】：中国贵航集团三0二医院骨科;
【基金】：安顺市科技局基金:安市科合【2015】23号
【分类号】：R687.3

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