| 半髋关节置换治疗高龄患者复杂股骨粗隆间骨折的临床体会 |
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投稿时间：2017-12-12 修订日期：2018-06-01
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
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| 基金项目:江苏省卫计委 妇女绝经后骨质疏松铁过载的中药治疗研究 课题编号：F201656 |
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| 中文摘要:摘要 目的 探讨半髋关节置换在治疗复杂股骨粗隆间的高龄骨折患者中的优缺点。
方法 我科从2013年8月到2017年1月回顾性研究了用关节置换或内固定治疗66例股骨粗隆间骨折的高龄患者，其中男20例，女46例，年龄80-95岁，平均85岁。根据改良Evans分型，其中III型33例，IV型24例，V型9例。31例既往有高血压，10例有糖尿病，12例有重度骨质疏松症，5例有房颤，3例有肺心病，1例有多发性骨髓瘤。关节置换组共34例和内固定术共32例，分别统计两组患者术中及术后出血量，并发症，Harris评分等。结果 关节置换组术中失血和术后失血分别为（320±20）ml和（200±25）ml，内固定组术中失血和术后失血分别为（350±30ml）ml和（250±30ml）ml，两组比较无统计学差异（p＞0.05）。所有患者得到随访，平均随访时间为2年。关节置换组的harris评分较高，两组并发症发生率有统计学差异（p＜0.05）。结论 股骨粗隆间骨折的高龄患者基础疾病多，预期生存期短，使用人工双极股骨头假体较内固定术可以及早及最大程度的恢复髋关节功能，使患者早期下床负重，有效降低内固定导致的并发症，提高患者生存质量及满意度,早期疗效高，是一种可以补充的治疗方式，符合快速康复外科和损伤控制理论，但不应扩大适应症，同时需加强围手术期的管理。
关键词 半髋关节置换 高龄患者 复杂 股骨粗隆间骨折关键词 半髋关节置换 高龄患者 复杂 股骨粗隆间骨折 |
| 【关键词】半髋关节置换 高龄患者 复杂 股骨粗隆间骨折 |
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| Clinical experience about hemiarthroplasty for the threatment of complicated femur intertrochanteric fracture in elderly patients |
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| ABSTRACT Abstract:Objective To discuss the hemiarthroplasty for the threatment of femur intertrochanteric fracture in elderly patients. Methods 66 elderly patients with complicated femur intertrochanteric fracture were recruited for this study from August 2013 to January 2017.there were 20 males and 46 females, aged80 - 95, with an average age of 85. According to improve Evans classification,there were 33 cases of type III,24 cases of typeIV,9 cases of type V.Most patients had basic disorders.All the patients underwent Hemiarthroplasty and 8"Word Cerclage Cable fixation or internal fixation. The revelant information(surgery time,blood loss,complication,harris score et al) were collected for statistical analysis. Results There were no difference between the surgery time and blood loss of Hemiarthroplasty group and internal fixation group（p＞0.05）.Anti-osteoporosis treatment were given post-operation.All the patients were followed up with an average of 24 months.The harris score of hemiarthroplsaty group was higher（p＜0.05）,while the complication rate of was significant lower than that of internal group（p＜0.05）. Conclusion For elderly patient with intertrochanteric hip fractures, hemiarthroplasty can retain function of hip joint.force patient out of bed in early phase,low down the complication，prolong life time，improve quality of life and degree of satisfaction. It also conform to the theory of fast-track surgery and injury control,but the indication should be control strictly.management of perioperative period should be enhanced.
Key words: Hemiarthroplasty of hip elderly patients complicated femur intertrochanteric fractureur intertrochanteric fracture |
| KEY WORDS Hemiarthroplasty of hip?elderly patients complicated femur intertrochanteric fracture |
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