本文選題：股骨頸骨折 + 糖尿病�。� 參考：《福建醫(yī)科大學》2015年碩士論文

【摘要】：目的:了解糖尿病在股骨頸骨折的三種手術治療方案中所產(chǎn)生的不同影響,為今后手術治療合并糖尿病的股骨頸骨折患者提供臨床經(jīng)驗。方法:本研究選取股骨頸骨折的手術患者477例為研究對象,按手術方式分為內固定組、全髖關節(jié)置換組及人工股骨頭置換組,再將每個手術組分為糖尿病組和非糖尿病組兩個亞組,并通過SPSS進行統(tǒng)計學分析療效和預后指標。結果:內固定組及全髖關節(jié)置換組的非糖尿病患者年齡較糖尿病患者小(P0.05),但在人工股骨頭置換組中兩亞組差異無統(tǒng)計學意義(P0.05)。三種術式的糖尿病組與非糖尿病患者在性別、入院時血紅蛋白、骨折部位、骨折分型、髖部骨折史差異上均無統(tǒng)計學意義(P0.05)。人工股骨頭置換組的糖尿病患者骨密度較非糖尿病組高(P0.01)。三種術式的糖尿病組在傷后至手術時間、術后住院時間、總住院時間均較非糖尿病組長(P0.05)。在骨折前內科合并癥中,三種術式的糖尿病患者合并高血壓的比例較非糖尿病組高(P0.05),行關節(jié)置換術的糖尿病與非糖尿病患者在心臟病(P0.05)、腦血管疾病(P0.05)患病率上有顯著差異,但行骨折內固定術的患者差異卻無統(tǒng)計學意義(P0.05)。在圍手術期并發(fā)癥中,人工股骨頭置換組的糖尿病患者心臟病發(fā)病率高于非糖尿病患者(P0.05)。關節(jié)置換組的糖尿病患者出現(xiàn)胃腸道癥狀的比例高于非糖尿病患者(P0.05)。三種術式的糖尿病患者在隨訪1年后的術后活動功能、疼痛評分及X線表現(xiàn)上與非糖尿病患者均無統(tǒng)計學差異(P0.05)。結論:相比非糖尿病患者,股骨頸骨折的糖尿病患者住院時間更長,骨折前內科合并癥及圍手術期并發(fā)癥發(fā)病率更高,且這種差異在不同手術方案中所表現(xiàn)的不全相同。但糖尿病患者在術后活動功能、疼痛評分及X線表現(xiàn)上與非糖尿病組相比差異均無統(tǒng)計學意義。對于糖尿病患者,應加強圍手術期血糖控制及術前內科合并癥、圍手術并發(fā)癥的處理,縮短住院時間。
[Abstract]:Objective: to investigate the different effects of diabetes mellitus in the treatment of femoral neck fracture, and to provide clinical experience for the treatment of femoral neck fracture with diabetes in the future. Methods: 477 patients with femoral neck fracture were divided into internal fixation group, total hip replacement group and artificial femoral head replacement group. Each operation group was divided into two subgroups: diabetic group and non-diabetic group. The curative effect and prognostic index were analyzed statistically by SPSS. Results: the age of non-diabetic patients in the internal fixation group and the total hip replacement group was lower than that in the diabetic group, but there was no significant difference between the two subgroups in the artificial femoral head replacement group (P 0.05). There was no significant difference in sex, hemoglobin at admission, fracture location, fracture classification and hip fracture history between the diabetic group and the non-diabetic group (P 0.05). Bone mineral density (BMD) in the artificial femoral head replacement group was higher than that in the non-diabetic group (P 0.01). The duration from injury to operation, postoperative hospitalization time and total hospitalization time of the three types of diabetes group were all higher than that of the non-diabetic group (P 0.05). In the prefracture internal medical complications, the proportion of diabetic patients with hypertension was higher than that of non-diabetic patients. There were significant differences in the prevalence of heart disease and cerebrovascular disease between the patients with joint replacement and those with non-diabetes mellitus (P 0.05, P 0.05), and there were significant differences in the prevalence of heart disease (P 0.05) and cerebrovascular disease (P 0.05) between the patients with joint replacement and non-diabetic patients. However, there was no significant difference in patients undergoing internal fixation of fractures (P 0.05). Among the perioperative complications, the incidence of heart disease in the artificial femoral head replacement group was higher than that in the non-diabetic group (P 0.05). The incidence of gastrointestinal symptoms in joint replacement group was higher than that in non-diabetic patients (P 0.05). There was no significant difference in postoperative motor function, pain score and X-ray findings between the three types of diabetic patients and non-diabetic patients (P 0.05). Conclusion: compared with non-diabetic patients, the patients with femoral neck fractures have longer hospitalization time, higher incidence of prefracture complications and perioperative complications. However, there was no significant difference in postoperative motor function, pain score and X-ray findings between diabetic patients and non-diabetic patients. For diabetic patients, we should strengthen perioperative blood glucose control, preoperative internal complications, perioperative complications, and shorten hospital stay.
【學位授予單位】：福建醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3;R587.1

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相關期刊論文 前1條

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本文編號：1980297