关节置换治疗56例老年股骨颈骨折患者围术期安全性分析

摘要

目的探讨高龄股骨颈骨折髋关节置换术的围术期安全性。方法回顾性分析56例行髋关节置换术的65岁以上老年髋部骨折病例资料。结果56例中54例平均住院21 d（18～31 d）顺利出院，Harris 评分从术前30分（0～38分）增加至出院时83分（72～91分），髋关节功能明显改善；围术期死亡2例，均为术前手术耐受力评分较差；术后形成血肿3例（5．4％），血肿穿刺后继发感染1例（1．79％），术后早期后脱位3例（5．4％），无1例有临床症状的深静脉血栓发生。结论髋关节置换术是治疗高龄股骨颈骨折的有效手段，但是，手术耐受能力较差者应慎重选择手术。%Objective To investigate the safety of hip arthroplasty during the perioperative period in aged patients with femoral neck fracture .Methods The clinical data in 56 elderly cases of femoral neck fracture treated by hip arthroplasty ,aged more than 65 years old ,were performed the retrospective analysis .Results Among 56 cases ,54 cases hospitalized for 21d[(18-31)d] and suc-cessfully were discharged ,the Harris scores were increased from preoperative 30 (0 -38) to postoperative 83 (72 -91) ,the func-tion of hip joint was obviously improved ;2 cases with the preoperative poor tolerance score died during perioperative period ,there were 3 cases(5 .4% ) of postoperative hip hematoma ,1 cases(1 .79% ) of postoperative hematoma developed secondary bacterial in-fection after puncture and 3 cases (5 .4% ) of postoperative posterior dislocation in the early stage and no case of deep venous thrombosis (DVT) accompanying clinical symptoms .Conclusion Hip arthroplasty is a effective measure for treating aged patients with femoral neck fracture .But those patients with poor operative tolerance should select this operation cautiously