本文選題：內(nèi)固定術(shù) + 全髖關(guān)節(jié)置換術(shù)�。� 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的比較多枚加壓螺釘內(nèi)固定術(shù)、全髖關(guān)節(jié)置換術(shù)和人工股骨頭置換術(shù)治療老年移位型股骨頸骨折的近期療效。方法通過回顧性分析我院自2008年2月至2013年10月間收治并且獲得完整隨訪的70例老年股骨頸骨折患者,按照手術(shù)方式不同分為三組,A組為多枚加壓螺釘內(nèi)固定組(n=20),B組為全髖關(guān)節(jié)置換術(shù)組(n=27),C組為人工股骨頭置換術(shù)組(n=23)。比較三種手術(shù)方式的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后臥床時(shí)間、醫(yī)療費(fèi)用,術(shù)后并發(fā)癥的發(fā)生率、以及隨訪1-3年以后髖關(guān)節(jié)功能評(píng)分。結(jié)果A組在手術(shù)時(shí)間、術(shù)中出血量要少于B、C組(P0.05)。而A組在術(shù)后下地負(fù)重時(shí)間明顯晚于B、C兩組(P0.05),且術(shù)后并發(fā)癥的發(fā)生率高于B、C兩組(P0.05)。三組醫(yī)療費(fèi)用均有差異,B組最高,C組次之,A組最少,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后1-3年Harris評(píng)分的優(yōu)良率B、C兩組高于A組,與A組差異存在統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后1-2年B、C兩組之間差異沒有統(tǒng)計(jì)學(xué)意義(P0.05),而術(shù)后3年Harris評(píng)分的優(yōu)良率B組高于C組,差異存在統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論對(duì)于老年移位型股骨頸骨折,臨床上更傾向選擇關(guān)節(jié)置換術(shù)。如果患者的年齡、預(yù)期壽命、身體情況以及經(jīng)濟(jì)條件允許,建議行全髖置換術(shù)。
[Abstract]:Objective to compare the short term effects of multiple compression screws internal fixation total hip arthroplasty and artificial femoral head replacement in the treatment of displaced femoral neck fractures in the elderly. Methods 70 elderly patients with femoral neck fracture who were admitted to our hospital from February 2008 to October 2013 were retrospectively analyzed. According to the different operation methods, three groups were divided into three groups: group A: multiple internal fixation with compression screws (n = 20) and group B: total hip arthroplasty (n = 27) and group C: artificial femoral head replacement (n = 23). The operative time, blood loss, bed-rest time, medical expenses, incidence of postoperative complications and hip joint function score were compared among the three types of operation. Results the blood loss during operation in group A was less than that in group B (P 0.05). The weight loading time in group A was significantly later than that in group B (P 0.05), and the incidence of postoperative complications was higher than that in group B (P 0.05). There were differences in medical expenses among the three groups. Group B had the highest medical expenses and group C had the lowest. The difference was statistically significant (P0.05). The excellent and good rate of Harris score in group B was higher than that in group A in 1-3 years postoperatively (P0.05), but there was no significant difference between group B and group A in 1-2 years after operation (P0.05), but the excellent and good rate of group B was higher than that of group C 3 years after operation. The difference was statistically significant (P0.05). Conclusion in elderly patients with displaced femoral neck fractures, arthroplasty is more preferred. Total hip replacement is recommended if the patient's age, life expectancy, physical condition and financial conditions permit.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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