内固定及人工关节置换治疗老年股骨粗隆间骨折的效果及安全性对比.docVIP

内固定及人工关节置换治疗老年股骨粗隆间骨折的效果及安全性对比 　　[摘要] 目的 探讨比较内固定术与人工关节置换术治疗老年股骨粗隆间骨折的临床效果及安全性。 方法 选取本院收治的老年股骨粗隆间骨折患者88例，根据手术方式不同分为人工关节置换术组和内固定术组，每组44例，比较分析两组患者的临床治疗效果和安全性。 结果 人工关节置换术组临床治疗为优的比率和优良率分别为61.36%和90.91%，均显著高于内固定术组的45.45%和70.45%，差异有统计学意义（P0.05）；与内固定术组比较，人工关节置换术组的术中出血量明显减少，术后并发症发生率明显降低，差异有统计学意义（P0.05）。 讨论 人工关节置换术治疗老年股骨粗隆间骨折临床效果显著，安全性高，值得推广应用。 　　[关键词] 老年；股骨粗隆间骨折；内固定术；人工关节置换术 　　[中图分类号] R687.4 [文献标识码] B [文章编号] 1674-4721（2014）04（a）-0193-03 　　[Abstract] Objective To investigate and compare the clinical efficacy and safety of internal fixation and arthroplasty for intertrochanteric fracture in elderly.Methods 88 cases of elder patients with intertrochanteric fractures in our hospital were selected，and were divided into internal fixation group and arthroplasty group according to the different method.The clinical efficacy and safety of patients in two groups was compared and analyzed.Results The excellent ratio and total excellent ratio of the patients in arthroplasty group was 61.36% and 90.91%，was much higher than 45.45% and 70.45% in internal fixation group，the difference was significant （P0.05）.Compared with the patients in internal fixation group，intraoperative blood loss of patients in arthroplasty group was reduced significantly，and the ratio of postoperative complication was decreased significantly，there was significant difference （P0.05）.Conclusion The clinical efficacy and safety of arthroplasty for elder patients with intertrochanteric fracture is significant，and is suitable for active promotion and application in clinical practice. 　　[Key words] Elder；Intertrochanteric fracture；Internal fixation；Arthroplasty 　　目前，伴随着我国经济社会的不断发展，人们生活水平的日益提高，长寿老人的数目也进一步增多，并与世界同步迈入了老龄化社会的行列[1]。由于受到老年人自身体质较差等相关因素的影响，老年股骨粗隆间骨折的发病率亦迅速攀升，并已成为老年人群中的常见损伤之一。本文探讨和比较内固定术与人工关节置换术在老年股骨粗隆间骨折患者中的临床疗效与安全性。 　　1 资料与方法 　　1.1 一般资料 　　选取2012年1～12月本院收治的老年股骨粗隆间骨折患者88例，其中，男性40例，女性48例，年龄68～85岁，平均（77.35±8.41）岁，所有入选患者均经股骨粗隆间骨折临床诊断标准明确诊断，并通过全面系统的体格检查而严格排除全身重要脏器功能障碍及恶性肿瘤患者。按照Evans分型：Ⅲ型64例，Ⅳ型24例。根据手术方式的不同