本文選題：股骨粗隆間骨折　切入點：髖關(guān)節(jié)置換　出處：《安徽醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：研究背景股骨粗隆間骨折系中老年骨質(zhì)疏松患者常見骨折之一,約占成人骨折的3.1%,其中約65%為不穩(wěn)定型[1]。對患者的健康產(chǎn)生嚴重的威脅,若不及時診治,患者的死亡率升高。此類骨折手術(shù)治療方式有很多,目前較為流行的有股骨近端防旋髓內(nèi)釘內(nèi)固定和半髖關(guān)節(jié)置換。選擇何種術(shù)式更優(yōu)成為臨床工作中的一個重要問題。國內(nèi)外學者對上述2種術(shù)式均進行大量研究,然而對外側(cè)壁非完整型股骨粗隆間骨折治療方案的選擇的研究較少。研究目的對比分析半髖關(guān)節(jié)置換(FHR)與股骨近端防旋髓內(nèi)釘(PFNA)內(nèi)固定治療老年骨質(zhì)疏松性外側(cè)壁非完整型股骨粗隆間骨折的早期療效。了解兩種治療方式的臨床療效及特點,探討何者更適合此類患者,為臨床工作中股骨粗隆間骨折的治療方案的選擇提供依據(jù)。研究方法選擇2014年1月至2016年4月安徽醫(yī)科大學第三附屬醫(yī)院收治的64例老年骨質(zhì)疏松性外側(cè)壁非完整型股骨粗隆間骨折患者,行半髖關(guān)節(jié)置換的患者27例,設(shè)為FHR組;行股骨近端防旋髓內(nèi)釘內(nèi)固定的患者37例,設(shè)為PFNA組。比較兩組患者的手術(shù)時間、術(shù)中出血量、切口長度、術(shù)后負重時間、住院時間及術(shù)后2周、1個月、3個月、6個月髖關(guān)節(jié)Harris評分。結(jié)果64例患者均獲6~12個月隨訪,與PFNA組相比,FHR組患者術(shù)后負重時間、住院時間短,術(shù)后2周、1個月、3個月、6個月髖關(guān)節(jié)Harris評分高,但FHR組切口長度和手術(shù)時間較PFNA組長,差異有統(tǒng)計學意義(P0.05);FHR組術(shù)中出血量多于PFNA組,差異有統(tǒng)計學意義(P0.05)。結(jié)論FHR和PFNA治療老年骨質(zhì)疏松性外側(cè)壁非完整型股骨粗隆間骨折早期療效可靠,但FHR術(shù)后可更早、更快恢復髖關(guān)節(jié)功能。
[Abstract]:Background Intertrochanteric fracture of femur is one of the most common fractures in middle-aged and aged patients with osteoporosis, accounting for 3.1% of adult fractures, of which about 65% are unstable type [1]. The mortality rate is increasing. There are a lot of surgical treatments for this kind of fracture. At present, there are more popular internal fixation of the proximal femur anti-rotation intramedullary nail and the replacement of the half-hip joint. It is an important problem in the clinical work to choose the better operation method. Many scholars at home and abroad have done a lot of research on the above two methods. However, there are few studies on the treatment of non-complete femoral intertrochanteric fractures. Objective to compare and analyze the internal fixation of hemihip replacement (FHR) and proximal femoral intramedullary intramedullary nail (PFNA) in the treatment of senile patients with lateral osteoporosis. The early curative effect of nonintact femoral intertrochanteric fracture. To explore which is more suitable for such patients, To provide the basis for the treatment of intertrochanteric fracture of femur in clinical work. Methods 64 cases of senile osteoporotic lateral wall were selected from January 2014 to April 2016 in the third affiliated Hospital of Anhui Medical University. Patients with intertrochanteric fracture of femur, Twenty-seven patients with hemihip replacement were divided into FHR group and 37 patients with intramedullary nail fixation at the proximal end of femur were divided into PFNA group. The operation time, intraoperative bleeding volume, incision length, weight bearing time after operation were compared between the two groups. Results all 64 patients were followed up for 6 ~ 12 months. Compared with the PFNA group, the postoperative weight bearing time and hospitalization time were shorter than those in the PFNA group. The Harris score of hip joint in FHR group was higher than that in PFNA group at 2 weeks, 1 month, 3 months and 6 months postoperatively, but the incision length and operation time in FHR group were significantly higher than those in PFNA group, and the amount of intraoperative bleeding in FHR group was higher than that in PFNA group. Conclusion FHR and PFNA are effective in the treatment of nonintact intertrochanteric fracture of femur in elderly patients with osteoporosis, but the function of hip joint can be recovered earlier and faster after FHR.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.3

【參考文獻】

相關(guān)期刊論文 前8條

1 范曉東;趙新國;張敬堂;;PFNA與股骨頭置換治療高齡不穩(wěn)定股骨粗隆間骨折的早期臨床療效對比[J];安徽醫(yī)學;2016年08期

2 劉潮堅;蔡拉加;石昭宏;林劍雄;;半髖置換加鋼絲環(huán)扎術(shù)在高齡不穩(wěn)定粗隆間骨折的應用[J];創(chuàng)傷外科雜志;2016年05期

3 張世民;馬卓;杜守超;胡孫君;陶友倫;;股骨近端外側(cè)壁的解剖學研究及其對轉(zhuǎn)子間骨折內(nèi)固定的意義[J];中國臨床解剖學雜志;2016年01期

4 胡克立;胡海清;時宏富;周少懷;王度;王欣;張松;;PFNA內(nèi)固定與人工股骨頭置換術(shù)治療高齡不穩(wěn)定股骨粗隆間骨折的比較[J];中國骨與關(guān)節(jié)損傷雜志;2013年06期

5 劉文廣;劉勝厚;殷慶豐;肖士鵬;王韶進;;水泥型人工髖關(guān)節(jié)置換治療老年EvansⅠ-Ⅲ型粗隆間骨折股骨假體的生物力學特性[J];中國醫(yī)學科學院學報;2013年01期

6 王建超;方忠;李光輝;熊偉;肖駿;郭風勁;李鋒;;綜合康復治療對全髖關(guān)節(jié)置換術(shù)后早期并發(fā)癥預防作用的分析[J];中華物理醫(yī)學與康復雜志;2011年07期

7 黃公怡;;骨質(zhì)疏松性骨折的特點及臨床與研究進展[J];基礎(chǔ)醫(yī)學與臨床;2007年10期

8 杜心如;盧世璧;;骨質(zhì)疏松時股骨上段髓腔形態(tài)學特點及其臨床意義[J];中國臨床解剖學雜志;2006年06期

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