人工股骨头置换对高龄股骨转子间骨折患者术后疗效研究

摘要

Objective To study the curative efficacy of artificial femoral head replacement in treatment of elderly patients with intertrochanteric fracture and its effects on hip function and complications.Methods 80 elderly patients of intertrochanteric fracture who received therapy from June 2014 to June 2015 in our hospital were selected as research objects. According to draw method,those patients were divided into the experimental group (n=40)and the control group(n=40). The two groups were examined by CT before operation,given blood pressure and blood lipid control, and symptomatic treatment was performed,continuous epidural anesthesia was used. The control group was treated with internal fixation,while the experimental group was treated with artificial femoral head replacement. All patients were treated with routine anti infection and low molecular heparin calcium after treatment,the drainage tube was pull out in 48 hours. Then operation time,intraoperative blood loss,bed rest time,hospitalization time,VAS,Harris score,adverse reaction rate,treatment effect in two groups were compared.Results The operation time,intraoperative blood loss,bed rest time and hospital stay in the experimental group were significantly lower than the control group(P<0.05). The VAS score was significantly lower than the control group(P<0.05),the Harris score was significantly higher than the control group(P<0.05). The incidence of adverse reactions was significantly lower than the control group(P<0.05). The excellent and good rate of treatment was significantly higher than the control group(P<0.05).Conclusion Artificial femoral head replacement can quickly restore the patient's hip function,reduce complications, relieve pain and promote early limb exercise,is good for intertrochanteric fracture.%目的 研究人工股骨头置换对高龄股骨转子间骨折患者术后疗效、髋关节功能及并发症的影响.方法 收集2014年6月至2015年6月80例高龄股骨转子间骨折患者.按抽签法分组,分为观察组40例和对照组40例,两组术前采用CT检查,均给予控制血压、血脂,对内科疾病进行对症治疗,采用蛛网膜下腔-硬膜外麻醉.对照组采用髓内钉,观察组采用人工股骨头置换术治疗.术后均给予常规抗感染及低分子肝素钠抗凝治疗,48h内拔出引流管.观察两组手术时间、术中失血量、卧床休息时间、住院时间,VAS评分、Harris评分、不良反应发生率和治疗疗效.结果 观察组手术时间、术中失血量、卧床休息时间、住院时间均显著低于对照组(P<0.05);VAS评分显著低于对照组(P<0.05),Harris评分显著高于对照组(P<0.05);不良反应总发生率显著低于对照组(P<0.05);优良率显著高于对照组(P<0.05).结论 人工股骨头置换可快速恢复患者的髋关节功能,减少并发症,缓解疼痛,可促进早期患肢锻炼,对于治疗高龄股骨转子间骨折能够达到满意的疗效.