人工关节置换与内固定治疗高龄骨质疏松性不稳定型股骨粗隆间骨折的对比分析.docVIP

人工关节置换与内固定治疗高龄骨质疏松性不稳定型股骨粗隆间骨折的对比分析 　　[摘要] 目的 对比分析人工关节置换与内固定治疗高龄骨质疏松性不稳定型股骨粗隆间骨折的临床效果。 方法 将整群选取的2013年2月―2015年2月该院收治68例高龄骨质疏松性不稳定型股骨粗隆间骨折患者随机分为A组和B组，每组34例，其中A组行人工髋关节置换，B组行内固定术，比较两组患者手术时间、术中出血量、卧床时间、术后并发症、术后Harris评分及FRS评分的下降值。 结果 A组的手术时间、卧床时间以及术后并发症发生率明显低于B组，差异均有统计学意义（P0.05）； A组术后Harris评分和FRS评分下降值分别为（20.96±4.27）、（23.17±4.53）分明显低于B组的（30.18±5.92）、（32.74±6.29），差异均有统计学意义（P中国论文网 /6/view-7165153.htm 　　[关键词] 人工关节置换；内固定；骨质疏松性；不稳定型股骨粗隆间骨折 　　[中图分类号] R68 [文献标识码] A [文章编号] 1674-0742（2015）09（c）-0086-03 　　[Abstract] Objective To compare the curative effect between the arthroplasty and the internal fixation in treatment of instable femoral intertrochanteric osteoporotic fractures in senile patients. Methods 68 cases senile patients with instable femoral intertrochanteric osteoporotic fracture who were admitted to the hospital from February 2013 to February 2015 were randomly divided into A group and B group， and each group has 34 cases. The cases in A group was treated with arthroplasty， while B group was treated with internal fixation. Time of operation， blood-transfusion during operation， time of rest in bed postoperatively， operative complications and the postoperative decrease of Harris scores and FRS scores were compared between the two groups. Results The time of operation， time of rest in bed postoperatively， operative complications in A group were lower than that of B group， respectively， and there were significant difference between the two groups （P0.05）； The postoperative decrease of Harris scores and FRS scores were respectively 20.96±4.27， 23.17±4.53 in A group， which were significantly lower than that of B group （P 　　1 资料与方法 　　1.1 一般资料 　　将整群选取2013年2月―2015年2月该院收治68例高龄不稳定型股骨粗隆间骨折患者，所有患者经X线或CT检查诊断均为骨质疏松性骨折，身体情况均符合手术治疗。根据术式的不同将其随机分为A组和B组，每组34例。其中A组中男16例，女18例，年龄63～84岁，平均年龄（79.1±7.7）岁；跌倒伤20例，车祸伤14例；按Evans进行骨折分型[2]，其中骨折ⅢA型13例，ⅢB型13例，Ⅳ型8例；合并1种内科系统疾病的患者10例，合并两种内科系统疾病的患者14例，合并3种或3种以上内科系统疾病的患者10例。B组中男15例，女19例，年龄64～85岁，平均年龄（78.7±8.3）岁；跌倒伤21例，车祸伤13例；按Evans进行骨折分型，其中骨折ⅢA型12例，ⅢB型