本文選題：亞急診手術(shù) + 轉(zhuǎn)子間骨折��； 參考：《河南中醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的:股骨轉(zhuǎn)子間骨折是臨床常見的髖部骨折,尤其好發(fā)于老年人,隨著我國逐漸步入老齡化社會,也會有越來越多的轉(zhuǎn)子間骨折患者。老年人轉(zhuǎn)子間骨折后的致殘率和死亡率較高,不僅嚴(yán)重影響患者的生活質(zhì)量,也威脅患者的生命。老年人多合并有內(nèi)科疾病,且年齡偏大,骨折入院后,出于手術(shù)安全性和家屬意愿等諸多方面的原因,急診手術(shù)難以施行,老年人又不宜長時間臥床,因此我們選擇手術(shù)風(fēng)險相對較低,同時又可以縮短術(shù)前等待時間的亞急診手術(shù)來治療這類特殊的人群,并探討它的臨床效果和可行性。方法:選取2014年4月至2014年11月我院收治的符合研究標(biāo)準(zhǔn)的47例65歲以上高齡轉(zhuǎn)子間骨折患者的臨床資料。根據(jù)受傷至接受手術(shù)的時間為標(biāo)準(zhǔn)將患者分為2組,其中亞急診手術(shù)組(即傷后24h內(nèi)接受手術(shù))有20例,擇期手術(shù)組(受傷24h后接受手術(shù))有27例,所有患者均采用股骨近端防旋髓內(nèi)釘(PFNA)方法進(jìn)行微創(chuàng)固定。兩組從住院期間的并發(fā)癥、髖關(guān)節(jié)功能、骨折愈合時間、住院時間進(jìn)行統(tǒng)計比較。結(jié)果:47例患者全部獲得隨訪,時間4~7個月,平均5.4個月。亞急診手術(shù)組患者住院期間并發(fā)癥低于擇期手術(shù)組,兩組間差異具有統(tǒng)計學(xué)意義(P0.05);兩組骨折愈合時間分別為(13.1±1.8、13.6±1.2)周,差異無統(tǒng)計學(xué)意義(P0.05);末次隨訪時,亞急診手術(shù)組髖關(guān)節(jié)功能平均(82.7±5.8)分,擇期手術(shù)組平均(81.4±5.9)分,兩組間差異無統(tǒng)計學(xué)意義(P0.05);亞急診手術(shù)組和擇期手術(shù)組的住院時間分別為(12.1±1.6)d和(16.1±1.8)d,兩組間差異具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:通過傷后24h內(nèi)的亞急診手術(shù)治療老年轉(zhuǎn)子間骨折,不僅夠減少術(shù)后并發(fā)癥的發(fā)生,而且能減少住院的時間。
[Abstract]:Objective: intertrochanteric fracture of femur is a common hip fracture, especially in the elderly. With the aging society, there will be more and more intertrochanteric fractures in China. The high rate of disability and mortality after intertrochanteric fracture not only seriously affects the quality of life of the patients, but also threatens the life of the patients. Most of the elderly are complicated with internal medical diseases, and they are too old. After the fracture is admitted to hospital, the emergency operation is difficult to carry out and the elderly should not stay in bed for a long time because of the safety of the operation and the will of the family. Therefore, we choose sub-emergency surgery which is relatively low in risk and can shorten the waiting time before operation to treat this kind of special population, and to explore its clinical effect and feasibility. Methods: the clinical data of 47 patients with intertrochanteric fracture over 65 years old admitted to our hospital from April 2014 to November 2014 were selected. The patients were divided into two groups according to the time from injury to operation. There were 20 cases in the sub-emergency operation group (within 24 hours after injury) and 27 cases in the selective operation group (24 hours after injury). All patients underwent minimally invasive fixation with PFNAs at the proximal end of the femur. The complications, hip function, fracture healing time and hospitalization time were compared between the two groups. Results all 47 cases were followed up for 4 ~ 7 months (mean 5.4 months). The complications in the subemergency operation group were lower than those in the elective operation group, the difference was statistically significant (P 0.05), the fracture healing time of the two groups was 13.1 鹵1.8 鹵13.6 鹵1.2 weeks, and the difference was not statistically significant (P 0.05). The average score of hip joint function was 82.7 鹵5.8 in the sub-emergency operation group and 81.4 鹵5.9 in the elective operation group. There was no significant difference between the two groups (P 0.05), and the hospitalization time of the sub-emergency operation group and the elective operation group were 12.1 鹵1.6 days and 16.1 鹵1.8 days, respectively. The difference between the two groups was statistically significant (P 0.05). Conclusion: the treatment of intertrochanteric fracture in the elderly by subemergency operation within 24 hours after injury can not only reduce the incidence of postoperative complications, but also reduce the length of hospitalization.
【學(xué)位授予單位】：河南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 覃稚華,李社芳,李凡;96例老年結(jié)石性膽囊炎的急診手術(shù)治療[J];醫(yī)學(xué)新知雜志;2002年02期

2 阮立新,鄭秀玨;腦動靜脈畸形出血急診手術(shù)治療[J];中華外科雜志;2005年17期

3 房文峰,蔡學(xué)見,陳錚立,王玉海;急診手術(shù)治療腦動靜脈畸形出血39例[J];中國神經(jīng)精神疾病雜志;1999年02期

4 祁克愛,歐陽榮梅,許紅琳;急診手術(shù)治療顱內(nèi)動脈瘤破裂出血患者的護(hù)理[J];護(hù)士進(jìn)修雜志;2001年05期

5 蔣成,吳青,蔚們,張志明,王松;多發(fā)傷病人骨折的急診手術(shù)治療[J];四川醫(yī)學(xué);2002年12期

6 王旭光,劉超,李新文,張強(qiáng),穆春雷,王中;腦動靜脈畸形出血的診斷及急診手術(shù)治療[J];中華急診醫(yī)學(xué)雜志;2005年09期

7 黃漢昌,傅校明,賈文慶;腦動靜脈畸形出血的急診手術(shù)治療[J];急診醫(yī)學(xué);1999年01期

8 馬攀峰;急診手術(shù)治療大咯血[J];中國現(xiàn)代醫(yī)學(xué)雜志;2003年23期

9 方憲清;汪瑞;;腦動靜脈畸形破裂出血的急診手術(shù)治療[J];中華全科醫(yī)學(xué);2011年12期

10 陳鋒;朱金陵;;121例大咯血患者急診手術(shù)治療臨床分析[J];長江大學(xué)學(xué)報(自科版);2013年15期

相關(guān)會議論文 前5條

1 阮立新;林來鵬;李先鋒;;腦動靜脈畸形出血的急診手術(shù)治療[A];2008年浙江省神經(jīng)外科學(xué)學(xué)術(shù)年會論文匯編[C];2008年

2 黃航;陳行友;徐子明;;急診手術(shù)治療自發(fā)性小腦血腫59例分析[A];中國醫(yī)師協(xié)會神經(jīng)外科醫(yī)師分會第四屆全國代表大會論文匯編[C];2009年

3 蘇志偉;袁小建;;腫瘤性腸梗阻的急診手術(shù)治療的臨床分析[A];2009年浙江省外科學(xué)學(xué)術(shù)年會論文匯編[C];2009年

4 沈宏;黃李潔;張建民;陳高;傅偉明;趙學(xué)群;祝向東;朱永堅;徐錦芳;李立;;腦動靜脈畸形破裂伴出血急診手術(shù)治療(附22例報告)[A];2009年浙江省神經(jīng)外科學(xué)術(shù)年會論文匯編[C];2009年

5 陶麒麟;陳張根;賈兵;李p，

本文編號：2038446