人工股骨头置换术治疗转子间骨折效果研究.docVIP

人工股骨头置换术治疗转子间骨折的效果研究 　　摘要：目的 本文主要探讨人工股骨头置换术治疗转子间骨折的效果。方法 选取转子间骨折患者共计149例，根据治疗方法不同将149例患者分为A、B、C三组分别实施动力髋螺钉固定术（DHS）、防旋股骨近端髓内钉固定术（PHNA）、人工股骨头置换术。结果 A、C组患者的手术时间均比B组要长，其差异具有统计学意义（P0.05）；C组患者的卧床时间相较于A、B两组更短，其差异具有统计学意义（P0.05）；出血量A组多于B组，但少于C组；C组患者在术后3、6、9个月的Harris得分高于A组和B组，其差异具有统计学意义（P0.05）；A、B、C三组的治疗效果优良率分别为73.5%、82.0%、96.0%，组间差异具有统计学意义（P0.05）。结论 采用人工股骨头置换术安全性高、治疗效果好，值得进行临床推广和应用。 　　关键词：人工股骨头置换术；DHS；PHNA；治疗效果 　　Effect of Artificial Femoral Head Replacement for Intertrochanteric Fractures 　　GONG Xiao-dong，LIU Yong 　　（Department of Orthopedics，Yingshan Hospital of Traditional Chinese Medicine，Yingshan 637700，Sichuan，China） 　　Abstract：Objective To investigate the effect of artificial femoral head replacement in the treatment of intertrochanteric fractures.Methods A total of 149 patients with intertrochanteric fractures were selected.149 patients were divided into A，B and C groups according to different treatment methods. Dynamic hip screw fixation（DHS），anti-rotation proximal femoral nail fixation（PHNA），Artificial femoral head replacement.Results The time of operation in group A and C was longer than that in group B（P0.05）.The time of bed rest in group C was shorter than that in group A and B，and the difference was statistically significant（P0.05）；the amount of bleeding in group A was higher than that in group B，but less than group C；Harris score of group C was higher than that of group A and group B at 3，6 and 9 months after operation（P0.05）.The excellent and good rate of treatment was 73.5%， 82.0% and 96.0% in group A，B and C，respectively.The difference was statistically significant（P0.05）.Conclusion Artificial femoral head replacement with high safety，good therapeutic effect，worthy of clinical promotion and application. 　　Key words：Artificial femoral head replacement；DHS；PHNA；Therapeutic effect 　　股骨转子间骨折（intertrochanteric fractures of femur）是指股骨颈基底至小转子水平以上部位发生的骨折，属于老年人比较常见的损伤，由于转子间部位血液循环较为丰富，骨折后极少不愈合[1]。造成转子间骨折的常见原因为直接或间接暴力，同时，此处为骨囊性病变的好发部位之一，因此也可发生病理性骨折。转子间骨折的症状为：