發(fā)布時間：2018-10-23 07:03

【摘要】：目的:通過兩種手術(shù)方式—PFNA和外固定支架—治療老年股骨粗隆間骨折,客觀分析兩種手術(shù)方式的臨床療效,探討兩種手術(shù)方法各自的特點,為臨床選用合適手術(shù)方法治療老年股骨粗隆間骨折提供參考。方法:通過系統(tǒng)回顧,收集佛山市中醫(yī)院骨七科自2013年4月至2014年11月間住院治療的符合納入標(biāo)準(zhǔn)的老年股骨粗隆間骨折患者病例74例,其中34例采用PFNA治療,40例采用外固定架治療。對兩組患者的手術(shù)操作時間(分鐘)、術(shù)中出血量(毫升)、住院時間(天)、骨折臨床愈合時間(周)、并發(fā)癥情況進(jìn)行分析觀察,并作統(tǒng)計學(xué)分析。結(jié)果:外固定支架和PFNA在手術(shù)時間(35.20±5.11vs42.79±4.66分鐘)、術(shù)中出血量(4.95±1.06vs122.35±12.81毫升)、住院時間(8.07±2.15vs11.38±2.57天)、術(shù)后并發(fā)癥等方面比較差異均有統(tǒng)計學(xué)意義(P0.05),外固定支架手術(shù)時間短、出血少、住院時間短,兩組在骨折臨床愈合時間(11.00±1.24vs10.68±1.57周)無明顯差別(P0.05);術(shù)后并發(fā)癥方面PFNA組優(yōu)于外固定支架組。術(shù)后半年髖關(guān)節(jié)創(chuàng)傷后Harriss評分兩組對比無明顯差異(P0.05)。結(jié)論:PFNA和外固定支架在治療老年股骨粗隆間骨折方面均能取得不錯效果。外固定支架具有操作簡便、創(chuàng)傷小、出血少、尤其適合伴嚴(yán)重內(nèi)科疾病、手術(shù)耐受性差的老年人。雖然存在膝關(guān)節(jié)僵硬、針道感染等并發(fā)癥,但一般經(jīng)治療后基本能恢復(fù),是目前治療老年股骨粗隆間骨折的一種很好的方法,值得臨床推廣使用。
[Abstract]:Objective: to treat intertrochanteric fracture of the aged femur by PFNA and external fixation stents, and to analyze the clinical effect of the two surgical methods objectively, and to explore the characteristics of the two surgical methods. To provide a reference for the treatment of intertrochanteric fracture of femur. Methods: through systematic review, 74 elderly patients with intertrochanteric fracture of femur, who were hospitalized from April 2013 to November 2014 in Department of Bone of Foshan traditional Chinese Medicine Hospital, were collected. 34 cases were treated with PFNA and 40 cases with external fixator. The operative time (min), intraoperative bleeding volume (ml), hospitalization time (day), fracture healing time (week) and complications of the two groups were analyzed and analyzed. Results: there were significant differences in operative time (35.20 鹵5.11vs42.79 鹵4.66 minutes), intraoperative bleeding volume (4.95 鹵1.06vs122.35 鹵12.81 ml), hospitalization time (8.07 鹵2.15vs11.38 鹵2.57 days) and postoperative complications between external fixation stent and PFNA (P0.05). There was no significant difference in fracture healing time (11.00 鹵1.24vs10.68 鹵1.57 weeks) between the two groups (P0.05). The postoperative complications in PFNA group were better than those in external fixation stent group. There was no significant difference in Harriss score between the two groups half a year after operation (P0.05). Conclusion: PFNA and external fixator are effective in the treatment of intertrochanteric fracture. External fixator is easy to operate, less trauma, less bleeding, especially suitable for the elderly with severe internal diseases and poor surgical tolerance. Although there are complications such as knee joint stiffness and needle infection, it can recover after treatment. It is a good method for the treatment of intertrochanteric fracture of the femur in the elderly, and it is worth popularizing in clinic.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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相關(guān)期刊論文 前1條

1 婁延舉;姚一民;檀臻煒;李興鑫;陳一平;;局麻下外固定架治療高危病人股骨粗隆間骨折[J];中國骨與關(guān)節(jié)損傷雜志;2014年S1期

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本文編號：2288420