股骨近端防旋髓内钉治疗老年人髋部骨折疗效的相关因素分析.docVIP

精品论文 参考文献 股骨近端防旋髓内钉治疗老年人髋部骨折疗效的相关因素分析 黄乔（岳池县人民医院 四川广安 638300） 　　【摘要】目的 探讨股骨近端防旋髓内钉在老年人髋部骨折治疗中的疗效影响因素。方法 112 例老年股骨粗隆间骨折患者根据术后1 年Harris 髋关节功能评分分为A 组（功能良好，n=85）与B 组（功能较差，n=27），对比两组患者性别、年龄、骨折类型、ASA 分级、手术时机、手术时间及术后畸形等方面的差异，并进行Logistic 回归分析。结果 两组患者在年龄、骨折类型方面比较差异显著（P＜0.01），而在性别、术前ASA 分级、手术时机、手术时间、术后畸形等方面比较无统计学差异（P＞0.05）；经Logistic 回归分析发现，患者年龄及骨折类型均为疗效的独立影响因素(P＜0.05)。结论 高龄、骨折稳定性较差的老年髋部骨折患者股骨近端防旋髓内钉内固定治疗效果相对较差，且高龄、骨折稳定性差为股骨近端防旋髓内钉治疗老年髋部骨折疗效的独立影响因素。 　　【关键词】防旋髓内钉；髋部骨折；相关因素【中图分类号】 R2 【文献标号】 A 【文章编号】 2095-7165（2015）13-0014-02【Abstract】Objective To discuss the related factors of the clinical effects of PFNA in the treatment of elderly patients with hip fracture. Methods 112elderly patients with intertrochanteric fractures were divided into Group A(with good hip joint function, n=85) and Group B(with poor hip joint function,n=27), and gender, age, fracture type, ASA classification, operation timing, operation time and postoperative deformity were contrasted between the twogroups, and then Logistic regression analysis was performed. Results There were significantly difference in age and fracture type between the two groups(P＜0.01), but no significantly difference in gender, ASA classification, operation timing, operation time and postoperative deformity(P＞0.05); the age andfracture type were all the independent factors for the clinical effects of PFNA in the treatment of elderly patients with hip fracture. Conclusion Advancedage, poor stability fractures in elderly patients with hip fractures PFNA effect is relatively poor, and the advanced age, poor stability are the independentfactors for the clinical effects of PFNA in the treatment of elderly patients with hip fracture.【Key Words】Anti Rotation Intramedullary Nail; Fracture Of Hip; Related Factors 　　股骨粗隆间骨折是最为常见的股骨近端骨折，该病常见于老年患者。由于老年人多合并骨质疏松、抗压骨小梁减少等，同时又因股骨近端所承受力量较大，故较小的外力作用即可导致该部位骨折。 　　近年来随着我国社会人口老龄化进程的加剧，老年人股骨粗隆间骨折发病率越来越高［1］。美国每年约有一半以上的髋部骨折为股骨粗隆间骨折。关于股骨粗隆间骨折的治疗，保守治疗因难以达到理想复位，同时骨折愈合速度较慢，患者需长期卧床，肺部感染、尿路感染以及褥疮等并发症发生率较高，故多采取外科手术治疗