目的：分析研究人工股骨头置换与动力髋螺钉（DHS）内固定治疗高龄股骨粗隆间骨折患者的临床效果对比。方法选择2013年5月～2014年7月到我院就诊的160例高龄股骨粗隆间骨折患者，通过随机数字表法将这些患者分为关节组和DHS组，对于关节组中的患者采取人工股骨头置换，对于DHS组中的患者采取DHS内固定。结果 DHS组患者的手术时间以及术中、术后引流量明显比关节组低，两组数据的比较具有统计学意义（P＜0.05）；DHS组患者的住院时间比关节组患者低，但在统计学上没有明显的差异（P＞0.05）；关节组患者在手术后，下床时间明显比DHS组患者早（P＜0.05），患者在早期髋关节的功能也要显著好于DHS组中的患者（P＜0.05），然而经过多个月以后，两组患者的髋关节功能没有显著性的差别（P＞0.05）。结论对于高龄股骨粗隆间骨折患者应该以内固定的治疗方法做为首选的措施，应该慎重选用人工股骨头置换术，严格掌握它的适应性。%Objective To explore the clinical effect of artificial femoral head replacement and dynamic hip screw (DHS) internal fixation in the treatment of femoral intertrochanteric fracture in elderly patients.Methods 160 elderly patients with femoral intertrochanteric fractures who were in our hospital from May 2013 to July 2014 were randomly divided into joint group and DHS group. The joint group received artificial femoral head replacement, while the DHS group was treated with DHS internal fixation. Results The operation time, intraoperative drainage amount, and postoperative drainage amount of the DHS group were obviously shorter or less than those of the joint group (P<0.05), the differences were statistically significant. The hospitalization time of the DHS group was shorter than that of the joint group, while there was no statistical significance (P>0.05). In the joint group, the postoperative ambulation time was earlier than that of the DHS group (P<0.05), and the early stage of hip joint function recoveries were superior than those of the DHS group (P<0.05). There were no differences in the hip joint function recoveries between the two groups 2 months after operations (P>0.05). Conclusion The DHS internal fixation is the first choice in the treatment of femoral intertrochanteric fracture in elderly patients. The artificial femoral head replacement should be applied carefully and adhering its applicable scope strictly.
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