人工股骨头置换与DHS内固定治疗高龄股骨粗隆间骨折疗效比较.doc

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1、人工股骨头置换与DHS内固定治疗高龄股骨粗隆间骨折疗效比较吴少坚张志(广州医学院荔湾医院510170)【摘要】目的评价人工股骨头置换术治疗高龄股骨粗隆间骨折的临床效果。方法对2008年10月年10月分别采用人工股骨头置换术(关节置换组)和DHS内固定(DHS组)治疗的74例高龄股骨粗隆间骨折患者进行回顾性分析。结果随访1〜4年。DHS组手术时间、术中出血量明显少于关节置换组(P<0.05)o关节置换组术后下床负重时间明显早于DHS组(P<0.01)o两组术后Harris评分无明显差异(P>0.05),关节置换组的并发症发生率

2、明显低于DHS组(P&t;0.05)o结论人工股骨头置换术治疗高龄不稳定型股骨粗隆间骨折有较好的近期疗效，可使患者早期下床活动，减少骨折并发症，提高患者生活质量，是高龄股骨粗隆间骨折一种可行的治疗方法。但应严格掌握手术适应征。【关键词】股骨粗隆间骨折DHS人工股骨头置换术【中图分类号】R687【文献标识码】A【文章编号】2095-1752(2013)23-0390-03ThecomparativeeffectivenessofHemiarthroplastyanddynamichipscrewsineldlyintertrochante

3、ricfractureWushaojianZhangzhi(DepartmentofOrthopaedicsjheLiwanhospitalofGuangzhouMedicalCollage,510170)[Abstract]OBJECTIVEToevaluatetheclinicaleffectsofhemiarthroplastyineldlyintertrochantericfracture.METHODSAmongtheelderlypatientsofintertrochantericfracturewhoweretreate

4、dinourhospitalbetweenOctober2008andOctober2011,74casesarechosenrandomlytoprostheticreplacementgroupas''observedgroup"andDHStreatedgroupas"controlgroup".RESULTSAllcasesarefollow-upobservedfor1-4years.Nonewasinfected.AllindexeswereanalyzedbySPSS13.0.Theoperationtime(P<0

5、.05)andthebleedingvolume(P<0.01)ofDHSgroupwaslessthantheprostheticonewithsignificantdifference.Fortimeofpostoperativeofweight-bearing,theobservedgroupwasearlierthanthatofcontrolgroup,andtherewasasignificantdifference(P<0.01).WhenscoredbyHarrisStandards*therewasnosi

6、gn讦icantdifference(P>0.05).Throughfollowing-uptovisitthegroupswhohadoccurredcomplication,therewasasignificantdifference(P<0.05).CONCLUSIONComparedwithDHSinernalfixation,theprostheticreplacementinthetreatmentofelderlyunstableintertrochantericfractureshasavalueinshort-t

7、ermtherapeuticeffects,whichcanallowpatientstogetoutbedearlierforweight-bearing,andtorecoverwithpre-injuryactivitiesearlier;whichcanreducecomplicationandimprovethequalityoflifeinpatients.However;surgicalindicationsshouldbestrictlycontrolled.【Keywords]Intertrochantericfrac

8、turehemiarthroplastyDynamichipscrew随着人口老龄化，老年人股骨粗隆间骨折发生率不断升高。由于老年人有骨质疏松H多合并有其他内科病的情况，一定程度上影响了治疗效果。我院对20