發(fā)布時(shí)間：2018-09-15 07:04

【摘要】：目的：本課題主要通過(guò)收集分析相關(guān)資料,從兩組手術(shù)的術(shù)前及術(shù)后Harris評(píng)分(附表1),手術(shù)時(shí)間、術(shù)中出血量,術(shù)后并發(fā)癥、功能恢復(fù)情況、優(yōu)良率及相關(guān)功能評(píng)分等方面對(duì)比兩種治療方法,分析出針對(duì)高齡股骨轉(zhuǎn)子間骨折臨床中常用的兩種手術(shù)治療方法的優(yōu)缺點(diǎn),進(jìn)而探討出在臨床中更好的、適合患者的治療方法。方法：選擇2012年9月至2014年9月期間在成都中醫(yī)藥大學(xué)附屬醫(yī)院住院并符合納入標(biāo)準(zhǔn)的患者50例。將其隨機(jī)分成兩組,A組和B組,每組各25例。A組采用PFNA內(nèi)固定術(shù)進(jìn)行治療,B組采用人工半髖關(guān)節(jié)置換術(shù)進(jìn)行治療,兩組患者從術(shù)前開(kāi)始采集并記錄Harris評(píng)分結(jié)果；術(shù)中觀察并記錄手術(shù)時(shí)間、術(shù)中出血量；術(shù)后觀察并記錄術(shù)后髖關(guān)節(jié)功能恢復(fù)情況、術(shù)后下地時(shí)間、術(shù)后優(yōu)良率、術(shù)后并發(fā)癥、術(shù)后Harris評(píng)分。治療前后(術(shù)前術(shù)后)觀察指標(biāo)：1、一般觀察資料：病例的性別、年齡、手術(shù)部位、X線片分型等；2、術(shù)前Harris指數(shù)評(píng)分；3、療效性指標(biāo)：通過(guò)比較兩種不同手術(shù)方式的術(shù)前及術(shù)后Harris評(píng)分,手術(shù)時(shí)間、術(shù)中出血量,術(shù)后并發(fā)癥、術(shù)后下地時(shí)間、術(shù)后優(yōu)良率、術(shù)后Harris評(píng)分。結(jié)果：50例病人均得到有效隨訪。A組與B組術(shù)前、術(shù)后Harris評(píng)分相比較有統(tǒng)計(jì)學(xué)意義(p0.05),A組、B組患者術(shù)前與術(shù)后Harris評(píng)分相比較無(wú)統(tǒng)計(jì)學(xué)意義(p0.05),A組與B組手術(shù)時(shí)間相比較有統(tǒng)計(jì)學(xué)意義(p0.05),A組與B組術(shù)中出血量相比較有明顯統(tǒng)計(jì)學(xué)意義(p0.01),A組與B組下地時(shí)間相比較有統(tǒng)計(jì)學(xué)意義(p0.05),A組與B組術(shù)后并發(fā)癥相比較無(wú)統(tǒng)計(jì)學(xué)意義(p0.05),A組與B組術(shù)后優(yōu)良率相比較無(wú)統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論：PFNA內(nèi)固定術(shù)與半髖關(guān)節(jié)置換術(shù)均是治療高齡股骨轉(zhuǎn)子間骨折的有效方法,PFNA內(nèi)固定術(shù)具有手術(shù)時(shí)間短,術(shù)中出血少的優(yōu)點(diǎn),針對(duì)嚴(yán)重骨質(zhì)疏松患者效果較好；半髖關(guān)節(jié)置換術(shù)相對(duì)下地時(shí)間較早,如患者髖關(guān)節(jié)無(wú)明顯骨關(guān)節(jié)炎或患者預(yù)期壽命較短時(shí),半髖置換是一種良好的選擇。
[Abstract]:Objective: by collecting and analyzing the relevant data, the Harris score (schedule 1), operative time, intraoperative blood loss, postoperative complications and functional recovery of the two groups were analyzed, including the preoperative and postoperative Harris scores (schedule 1), the time of operation, the amount of blood lost during the operation, the complications after operation and the recovery of function. The excellent and good rate and the related functional score were compared. The advantages and disadvantages of the two operative methods in the treatment of intertrochanteric fracture of the femur were analyzed, and the better ones in clinic were discussed. Suitable treatment for patients. Methods: from September 2012 to September 2014, 50 patients who were admitted to the affiliated Hospital of Chengdu University of traditional Chinese Medicine and met the inclusion criteria were selected. The patients were randomly divided into two groups: group A (n = 25) and group B (n = 25). Group A was treated with PFNA internal fixation and group B was treated with artificial hemihip replacement. The results of Harris score were collected and recorded before operation. Observe and record the time of operation and the amount of blood loss, observe and record the recovery of hip joint function, the time of dropping down, the rate of excellent and good, the complication after operation, and the Harris score after operation. Before and after treatment (before and after treatment) observation index: 1, general observation data: case sex, age, surgical site X ray type and so on 2, preoperative Harris index score; 3Therapeutic index: by comparing the preoperative and postoperative Harris scores, operative time, intraoperative bleeding volume, postoperative complications, postoperative landing time, postoperative excellent and good rate, postoperative Harris score. Results all 50 patients were followed up effectively before operation in group A and group B. There was no significant difference in preoperative and postoperative Harris scores between group A and group B (p0.05). There was significant difference in the operative time between group A and group B (p0.05). The amount of intraoperative blood loss in group A was significantly higher than that in group B (p0.05). There was no significant difference in postoperative complications between group A and group B (p0.05). There was no significant difference in the excellent and good rate between group A and group B (p0.05). Conclusion the two effective methods for the treatment of femoral intertrochanteric fracture in the elderly are the internal fixation of the femur with 1% PFNA and half hip replacement. PFNA internal fixation has the advantages of short operation time and less intraoperative bleeding. The effect of PFNA is better for the patients with severe osteoporosis. Hemiarthroplasty is a good choice for patients who have no osteoarthritis or have a short life expectancy.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.4

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馬小明;;PFNA治療老年股骨粗隆間骨折[J];齊齊哈爾醫(yī)學(xué)院學(xué)報(bào);2011年14期

2 程宏振;周之平;;PFNA治療老年股骨粗隆間骨折[J];中國(guó)社區(qū)醫(yī)師(醫(yī)學(xué)專業(yè));2012年27期

3 周環(huán)玉;周宇;黃昕亮;;PFNA治療老年骨質(zhì)疏松性股骨粗隆間骨折[J];贛南醫(yī)學(xué)院學(xué)報(bào);2012年03期

4 李才應(yīng);平國(guó);馬波;;PFNA微創(chuàng)治療老年股骨粗隆間骨折療效分析[J];中國(guó)醫(yī)學(xué)工程;2014年01期

5 李萬(wàn)云;;PFNA治療老年股骨粗隆間骨折46例分析[J];中國(guó)醫(yī)學(xué)工程;2014年02期

6 韓書(shū)勇;王琪;;PFNA微創(chuàng)治療老年性股骨粗隆間骨折臨床體會(huì)[J];河南外科學(xué)雜志;2014年02期

7 彭渝萍;;PFNA治療老年股骨轉(zhuǎn)子周圍骨折的臨床療效觀察[J];基層醫(yī)學(xué)論壇;2014年25期

8 林焱斌;張怡元;馮爾宥;肖莉莉;李平;;PFNA微創(chuàng)治療高齡股骨轉(zhuǎn)子間骨折療效分析[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2008年06期

9 謝瑞群;張曉弘;王麗娟;;PFNA治療老年股骨粗隆間骨折術(shù)中的護(hù)理體會(huì)[J];福州總醫(yī)院學(xué)報(bào);2009年02期

10 石波;王軍;康斌;唐詩(shī)天;王陶;劉都;;PFNA治療老年股骨粗隆間骨折的回顧性分析[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2010年10期

相關(guān)會(huì)議論文 前10條

1 李科倫;黃忠勝;胡凱;趙政;;PFNA治療高齡股骨轉(zhuǎn)子間骨折的療效分析[A];2009年浙江省骨科學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2009年

2 李科倫;黃忠勝;胡凱;趙政;;PFNA治療高齡股骨轉(zhuǎn)子間骨折的療效分析[A];第七屆全國(guó)創(chuàng)傷學(xué)術(shù)會(huì)議暨2009海峽兩岸創(chuàng)傷醫(yī)學(xué)論壇論文匯編[C];2009年

3 郭禮躍;黃維琛;李路;呂翔;孟映福;;PFNA治療高齡股骨轉(zhuǎn)子間骨折62例臨床報(bào)道[A];貴州省中西醫(yī)結(jié)合學(xué)會(huì)骨傷分會(huì)第二次學(xué)術(shù)交流會(huì)議論文匯編[C];2011年

4 蔣新艷;;PFNA治療老年股骨粗隆間骨折的手術(shù)配合[A];創(chuàng)建患者安全文化——中華護(hù)理學(xué)會(huì)第15屆全國(guó)手術(shù)室護(hù)理學(xué)術(shù)交流會(huì)議論文匯編（下冊(cè)）[C];2011年

5 陳文輝;甘俊松;張正茂;蔣賽;;PFNA一Ⅱ微創(chuàng)治療高齡股骨轉(zhuǎn)子間骨折[A];2012年浙江省骨科學(xué)術(shù)年會(huì)論文集[C];2012年

6 江淮;呂建軍;許俊勝;程文丹;曹慶;吳小三;;應(yīng)用PFNA治療老年骨質(zhì)疏松性股骨粗隆間骨折[A];中華醫(yī)學(xué)會(huì)第七次全國(guó)骨質(zhì)疏松和骨礦鹽疾病學(xué)術(shù)會(huì)議論文匯編[C];2013年

7 樂(lè)軍;彭亮;呂建華;項(xiàng)東;;PFNA治療老年股骨粗隆間骨折療效及并發(fā)癥[A];2009年浙江省骨科學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2009年

8 朱宗昊;李凡;王秋根;李豪青;陶杰;高偉;黃建華;;PFNA治療老年不穩(wěn)定性股骨轉(zhuǎn)子周圍骨折68例[A];第二屆泛長(zhǎng)江流域骨科新進(jìn)展研討會(huì)暨上頸椎傷病新理論新技術(shù)學(xué)習(xí)班論文匯編[C];2008年

9 戶小彬;王大衛(wèi);張津生;曾憲鐵;;PFNA結(jié)合中醫(yī)治療老年股骨粗隆間骨折的臨床體會(huì)[A];第二十屆全國(guó)中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會(huì)、第二屆中國(guó)醫(yī)師協(xié)會(huì)中西醫(yī)結(jié)合醫(yī)師分會(huì)骨傷科學(xué)術(shù)年會(huì)、第十九屆浙江省中西醫(yī)結(jié)合骨傷科專業(yè)委員會(huì)學(xué)術(shù)年會(huì)論文匯編[C];2013年

10 戶小彬;王大衛(wèi);張津生;;微創(chuàng)PFNA結(jié)合中醫(yī)治療老年股骨粗隆間骨折[A];第三屆全國(guó)中西醫(yī)結(jié)合骨科微創(chuàng)學(xué)術(shù)交流會(huì)論文匯編[C];2013年

相關(guān)碩士學(xué)位論文 前10條

1 胡楊;PFNA治療老年人股骨轉(zhuǎn)子間骨折[D];重慶醫(yī)科大學(xué);2012年

2 銀曉永;PFNA治療老年股骨粗隆間骨折術(shù)后早期療效分析[D];河北醫(yī)科大學(xué);2015年

3 王添;PFNA治療老年股骨粗隆間骨折的臨床研究[D];山東中醫(yī)藥大學(xué);2011年

4 王思元;PFNA治療老年股骨粗隆間骨折的初步經(jīng)驗(yàn)[D];山東中醫(yī)藥大學(xué);2011年

5 李偉;PFNA與外固定支架治療老年股骨粗隆間骨折療效的對(duì)比分析[D];遼寧中醫(yī)藥大學(xué);2015年

6 許京偉;微創(chuàng)PFNA治療老年股骨粗隆間骨折的臨床療效觀察[D];山東中醫(yī)藥大學(xué);2012年

7 李磊;高齡股骨轉(zhuǎn)子間骨折PFNA內(nèi)固定與半髖關(guān)節(jié)置換手術(shù)療效對(duì)比研究[D];成都中醫(yī)藥大學(xué);2015年

8 梁虎;PFNA在老年股骨粗隆間骨折中的療效分析[D];延邊大學(xué);2012年

9 黃漫華;股骨轉(zhuǎn)子間骨折PFNA固定術(shù)后隱性失血及其相關(guān)因素的研究[D];廣州中醫(yī)藥大學(xué);2015年

10 陳朝;PFNA-Ⅱ與InterTan髓內(nèi)釘治療股骨轉(zhuǎn)子間骨折對(duì)比分析[D];廣州中醫(yī)藥大學(xué);2015年

，

本文編號(hào)：2244122