本文選題：高齡股骨粗隆間骨折 + 股骨近端鎖定接骨板��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：【目的】分析股骨近端鎖定接骨板(LPFP)、股骨近端防旋髓內(nèi)釘(PFNA)及雙極人工股骨頭置換(BPH)治療高齡老年人股骨粗隆間骨折的臨床效果�！痉椒ā炕仡櫺苑治�86例自2011年6月至2016年8月采用LPFP、PFNA內(nèi)固定及BPH治療75歲以上高齡股骨粗隆間骨折患者臨床資料,各組:LPFP組男10例,女16例;PFNA組男17例,女22例;BPH組男9例,女12例。LPFP組年齡72.54±4.78歲;PFNA組年齡74.41±5.65歲;BPH組年齡76.23±6.97歲。平均病程2~3月。LPFP組中EvansⅡ型5例,Ⅲ型12例,Ⅳ型9例;PFNA組中EvansⅡ型11例,Ⅲ型18例,Ⅳ型10例;BPH組中EvansⅡ型1例,Ⅲ型10例,Ⅳ型10例。比較3組手術(shù)時間、術(shù)中出血量、住院時間、術(shù)后并發(fā)癥發(fā)生率和髖關(guān)節(jié)功能Harris評分�！窘Y(jié)果】術(shù)后患者傷口愈合良好,無并發(fā)癥發(fā)生。84例獲得隨訪,2例失訪(隨訪率為97.6%)。術(shù)后隨訪42~62個月,平均46.3個月。(一)手術(shù)時間及住院時間比較中,BPH組明顯比LPFP組和PFNA組明顯縮短,具有統(tǒng)計學(xué)差異(F=19,782,21.981;P0.05);LPFP組和PFNA組2組組間比較中,LPFP組與PFNA組無統(tǒng)計學(xué)差異(T=-0.21,P0.05)。(二)術(shù)中出血量的比較中,BPH組比PFNA組和LPFP組明顯減少,差異有統(tǒng)計學(xué)意義(F=12.976,P0.05);PFNA組與LPFP組2組的組間比較無顯著差異(T=0.879,P0.05)。(三)術(shù)后并發(fā)癥發(fā)生率的比較中,LPFP組較PFNA組和BPH組高,差異有統(tǒng)計學(xué)意義(F=30.976,P0.05);PFNA組與BPH組間比較無顯著差異(T=0.902,P0.05)。(四)術(shù)后3周關(guān)節(jié)Harris評分的比較中,BPH組得分高于LPFP組及PFNA組,差異有統(tǒng)計學(xué)意義(F=32.871,P0.05);術(shù)后6個月及2年髖關(guān)節(jié)功能Harris評分的比較中,PFNA組和BPH組均優(yōu)于LPFP組(F=42.871,P0.05),而PFNA組與BPH 2組組間比較無顯著差異(T=4.971,P0.05)�！窘Y(jié)論】對于全身情況較差的高齡患者(75歲),BPH手術(shù)時間短,術(shù)后并發(fā)癥少,是最優(yōu)的選擇。對于單純的股骨粗隆間骨折患者,PFNA也具有明顯的優(yōu)勢,術(shù)者可根據(jù)情況選擇。對于高齡的股骨粗隆間骨折患者,不建議應(yīng)用LPFP。
[Abstract]:[objective] to analyze the clinical effect of LPFP, PFNAand bipolar artificial femoral head replacement in the treatment of femoral intertrochanteric fractures in elderly patients. [methods] 86 cases of femoral intertrochanteric fractures were retrospectively analyzed since 2011. [objective] to analyze the clinical effect of LPFPN, PFNAand bipolar artificial femoral head replacement in the treatment of femoral intertrochanteric fractures in the elderly. [methods] 86 cases of femoral intertrochanteric fractures were retrospectively analyzed. From June 2000 to August 2016, patients with intertrochanteric fracture of femur were treated with LPFPN PFNA and BPH. There were 10 males, 17 females in PFNA group, 9 males in BPH group and 12 females in LPFP group. The age of PFNA group was 72.54 鹵4.78 years old. The age of BPH group was 76.23 鹵6.97 years old. There were 5 cases of Evans type 鈪，

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