碳质涂膜人工股骨头置换修复老年股骨不稳定合并骨质疏松性骨折

摘要

背景：老年人较易发生不稳定性合并骨质疏松性股骨骨折，临床对其进行修复治疗的过程中，可以采取不同的方案，以往大多实施内固定治疗。但目前关于老年股骨不稳定合并骨质疏松性骨折修复方法的具体选择，尚存在一定的争议。　　目的：观察碳质涂膜人工股骨头置换修复老年股骨不稳定合并骨质疏松性骨折的随访结果。　　方法：回顾性分析西安交通大学医学院附属红会医院2013年2月至2014年2月收治的83例老年股骨不稳定合并骨质疏松性骨折患者的临床资料，按照修复方法分为对照组(42例)和观察组(41例)，分别实施常规内固定治疗和人工股骨头置换治疗。观察两组患者的手术所用时间、术中出血量、术后卧床时间及住院天数；随访12个月，观察两组患者的髋关节功能恢复情况以及并发症发生情况，并进行比较。　　结果与结论：观察组手术所用时间和术中出血情况与对照组比较差异无显著性意义(P>0.05)，但观察组的术后卧床时间和住院天数均显著短于对照组(P<0.05)。观察组的治疗后髋关节功能优良率显著高于对照组，并发症发生率则显著低于对照组(P<0.05)。表明对老年股骨不稳定合并骨质疏松性骨折患者实施碳质涂膜人工股骨头置换可以获得较好的修复效果，对患者造成的损伤小，并发症少，且可以更好的改善患者的髋关节功能。%BACKGROUND:Elderly patients are more prone to unstable and osteoporotic fractures. In the clinical surgical treatment, different programs can be taken. Internal fixation was done previously. However, the precise choice of the methods of unstable and osteoporotic femoral fractures in the elderly was stil controversial. OBJECTIVE:To investigate the clinical effect of carbon-coated artificial femoral head replacement in the treatment of elderly patients with unstable and osteoporotic femoral fractures. METHODS:A retrospective analysis was performed in the Honghui Hospital Affiliated to Health Science Center, Xi’an Jiaotong University from February 2013 to February 2014 in 83 cases of unstable and osteoporotic femoral fractures. These patients were divided into control group (42 cases) and observation group (41 cases) according to treatment methods. Conventional internal fixation and artificial femoral head replacement were conducted. Operation time, intraoperative blood loss, postoperative bed time and hospital stay were observed in the two groups. Patients were fol owed up for 12 months. Recovery of hip function and complications were observed and compared between the two groups. RESULTS AND CONCLUSION:No significant difference in operation time and intraoperative blood loss was detected between the observation group and the control group (P>0.05). Postoperative bed time and hospital stay were significantly shorter in the observation group than in the control group (P<0.05). The excel ent and good rate of hip joint function was significantly higher in the observation group than in the control group, but the complication rate was significantly lower in the observation group than in the control group (P<0.05). These findings suggest that carbon-coated artificial femoral head replacement for unstable and osteoporotic femoral fractures in the elderly obtained good repair effects, had smal injury to the patient and less complications. Moreover, it can better improve hip function.