人工股骨头置换治疗高龄股骨颈骨折疗效研究.docVIP

人工股骨头置换治疗高龄股骨颈骨折疗效研究【摘要】目的:探讨人工股骨头置换术治疗高龄股骨颈骨折的疗效。方法:对我院2004年1月～2008年12月收治的72例高龄股骨颈骨折行人工关节股骨头术治疗。并进行了10～40个月(平均21个月)的随访。结果:临床疗效按Harris评分标准。本组优良(≥80分)67例,占93.1%;尚可(70～79分)4例,占5.5%;差(70分)1例,占1.3%。结论:高龄股骨颈骨折患者行人工关节置换术治疗,具有创伤小、手术时间短、减少卧床并发症,恢复髋关节功能等优点,是一种比较理想的治疗手段。 【关键词】股骨颈骨折;股骨头置换;高龄 【中图分类号】R687.3+4【文献标识码】A【文章编号】1007-8517(2010)12-082-2 Effect of Artificial Hip Arthroplasy in Treatment of Senile Femoral neck Fracture Tao Jun,Dong Bin,Cui Haiyong. Department of Orthopaedic,First Peoples hospital of Huainan City,anhui,232007,China 【Abstract】Objective:To investigate therapeutic effects of femoral neck fracture with artificial joint replacement in senile patients. Methods:From Jan.2004 to Dec.2008,72 patients with femoral neck fracture were operated using artificial joint replacement. Patients were followed up for 10 months to 40 months. The average period of follow-up was 21 months. Results:The clinical effect was judged by Harris score system. 67 patients scored ≥80points,4 patients 70～79 points,and I patient70 points. Conclusions:The method of artificial joint replacement is rather ideal method to treat the femoral neck fracture. It can recover movements of hip joint and decrease the complication rate of lying in bed and presented advantages of little wound and little time of operation. 【key words】Femoral neck fracture;Replacement;Senile;Elder patients 随着我国人口的老龄化,我国老年人目前已达12.6%,绝对数可过1.64亿。高龄老年人因骨质疏松等因素,易发生骨折,尤其是股骨颈骨折,已经成为常见病、多发病之一。为了提高老年人的生命价值和生活质量,从2004年1月到2008年12月我院采用人工关节置换治疗70岁以上的高龄股骨颈骨折患者72例,本文就人工关节置换治疗高龄股骨颈骨折的疗效进行回顾性分析。 1资料与方法 1.1一般资料 本组72例,男19例,女53例;年龄70～94岁,平均年龄74.7岁;致伤原因:走路滑倒60例,车祸外伤12例。骨折分类:均为新鲜骨折;按Garden分型:Ⅰ型21例,Ⅱ～Ⅳ型51例;所有患者入院后经X线检查均未见明显髋臼损伤。术前检查64例有合并症,占88.89%,2种以上合并症者52例,占72.2%,其中糖尿病39例,高血压病43例,冠心病26例,慢支肺气肿8例,脑血管疾病11例,偏瘫2例。术前常规检查,对合并糖尿病患者术前用胰岛素治疗,使其空腹血糖8mmol/L。对高血压病人术前控制血压在正常水平。对脑梗死及慢性肺气肿等重要脏器功能障碍者,经相关科室会诊治疗后无禁忌,才考虑手术治疗。 1.2治疗方法 本组72例均采用连续硬膜外麻醉手术治疗。均行双极人工股骨头置换术;骨水泥固定54例,非骨水泥固定18例;采用外侧小切口;切口负压引流24～48小时;术后行皮肤牵引或穿矫形鞋,患肢外展中立