本文選題：股骨頸骨折 + 手術(shù)方法��； 參考：《大連醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:討論治療股骨頸骨折采用兩種不同手術(shù)方法的臨床治療效果;討論股骨頸骨折傷后到手術(shù)不同手術(shù)時機(jī)內(nèi)固定對臨床效果的影響。方法:研究對象在長治醫(yī)學(xué)院附屬和濟(jì)醫(yī)院骨科(在2011年6月至2012年10月接受診療)選取病例,共收集到各項(xiàng)條件相近的移位型股骨頸骨折病例121例,來進(jìn)行回顧性分析。在這些病例中內(nèi)固定治療的病例共有86例,而全髖關(guān)節(jié)置換的病例共有35例,按不同手術(shù)方式進(jìn)行手術(shù)情況(手術(shù)時間、術(shù)中出血量)、并發(fā)癥(傷口感染、肺部感染、患側(cè)深靜脈血栓)和關(guān)節(jié)Harris評分(疼痛、功能、活動范圍)比較。在86例內(nèi)固定病例中,按手術(shù)距離受傷時間(以24小時為標(biāo)準(zhǔn))再分組,非急診手術(shù)組(45例)為手術(shù)距離受傷時間≥24 h的患者,而受傷到手術(shù)的時間≤24 h的患者作為急診手術(shù)組(41例)。內(nèi)固定患者均行閉合復(fù)位內(nèi)固定手術(shù)治療。180天后對這86名患者進(jìn)行觀察,指標(biāo)包括發(fā)生并發(fā)癥情況、關(guān)節(jié)功能評價、X線提示的骨折愈合情況。并且在86例內(nèi)固定手術(shù)患者非急診手術(shù)組(受傷到手術(shù)的時間≥24 h)與急診手術(shù)組(受傷到手術(shù)的時間≤24 h)進(jìn)行骨折愈合,關(guān)節(jié)Harris評分、并發(fā)癥的比較。結(jié)果:1不同手術(shù)方式比較:全髖組術(shù)中出血量及手術(shù)時間明顯高于內(nèi)固定組(P0.01)。2不同手術(shù)方式關(guān)節(jié)功能比較:內(nèi)固定組較全髖組關(guān)節(jié)功能差(P0.05)。3不同手術(shù)方式比較:內(nèi)固定組較全髖組并發(fā)癥發(fā)生率高(P0.01)。4相同手術(shù)方式(內(nèi)固定)不同手術(shù)時機(jī)的比較:(1)X線提示的骨折愈合率:急診手術(shù)組較非急診手術(shù)組高(P0.05)。(2)對于內(nèi)固定患者,急診手術(shù)組髖關(guān)節(jié)功能明顯高于非急診手術(shù)組(P0.05)。(3)并發(fā)癥發(fā)生率:急診手術(shù)組較非急診手術(shù)組發(fā)生率低(P0.05)。結(jié)論與內(nèi)固定手術(shù)治療股骨頸骨折相比,全髖關(guān)節(jié)置換具有并發(fā)癥少、關(guān)節(jié)功能優(yōu)的特點(diǎn),但同時巨有手術(shù)創(chuàng)傷大,圍手術(shù)期手術(shù)風(fēng)險高的特點(diǎn);若選擇內(nèi)固定手術(shù),為降低并發(fā)癥,提高治療的總效果,盡量在傷后24 h內(nèi)進(jìn)行手術(shù)治療。
[Abstract]:Objective: to discuss the clinical effect of two different surgical methods in the treatment of femoral neck fracture, and discuss the influence of internal fixation after fracture of femoral neck to different operative time. Methods: 121 cases of displaced femoral neck fractures were collected from orthopaedics department of Heji Hospital affiliated to Changzhi Medical College from June 2011 to October 2012 for retrospective analysis. Of these cases, 86 were treated with internal fixation and 35 with total hip replacement, according to different surgical procedures (operative time, intraoperative bleeding, complications (wound infection, pulmonary infection), The Harris score (pain, function, and range of movement) of the affected deep vein thrombosis was compared with that of the joint. Among 86 cases of internal fixation, 45 cases of non-emergency operation group were divided into two groups according to the time of operation distance injury (according to the standard of 24 hours), and 45 cases of non-emergency operation group were patients with the injury time of operation distance 鈮，

本文編號：1862195