人工关节置换术与内固定术治疗老年股骨转子间骨折的效果比较(1)
[摘要] 目的 比较人工关节置换术与内固定术治疗老年股骨转子间骨折的效果。 方法 回顾性分析2013年1月～2015年1月北京中医药大学东直门医院收治的83例股骨转子间骨折患者的临床资料，并按照手术方法的不同将其分为人工关节置换术组(36例)、内固定术组(47例)。观察比较两组患者手术时间、术中出血量及卧床时间，记录两组术后3、6、12个月Harris髋关节功能评分，分析两组术后1年并发症发生情况。 结果 人工关节置换术组手术时间[(85.37±20.18)h]明显长于内固定术组[(69.28±17.51)h]，术中出血量[(150.48±42.53)mL]明显多于内固定术组[(104.73±27.84)mL]，卧床时间[(8.19±2.42)d]明显短于内固定术组[(11.58±3.13)d]，差异均有统计学意义(均P < 0.05)。人工关节置换术组术后3、6、12个月Harris髋关节功能评分均高于内固定术组，但差异无统计学意义(P > 0.05)。术后随访1年，人工关节置换术组并发症发生率(16.67%)明显低于内固定术组(29.79%)，差异有统计学意义(P < 0.05)。 结论 人工关节置换术与内固定术治疗老年股骨转子间骨折各有优缺点，因此术前评估极其重要，应根据患者的具体情况采用不同的术式，最大程度地提高患者髋关节功能，改善预后。
[关键词] 人工关节置换术；内固定术；股骨转子间骨折；老年；效果
[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210(2016)06(c)-0101-04
[Abstract] Objective To compare the effect of artificial joint replacement and internal fixation in the treatment of elderly patients with intertrochanteric fracture. Methods The clinical data of 83 cases with intertrochanteric fracture admitted to Dongzhimen Hospital， Beijing University of Chinese Medicine from January 2013 to January 2015 was analyzed retrospectively. The patients were divided into artificial joint replacement group (36 cases) and internal fixation group (47 cases) according to different surgical methods. The operation time， intraoperatve blood loss and the time in bed of the two groups were compared； the Harris hip scores of the two groups at 3， 6， 12 months after operation were recorded； the complication after operation for 1 year of the two groups were analyzed. Results The operation time[(85.37±20.18) h] of artificial joint replacement group was longer than that of internal fixation group [(69.28±17.51) h]， the intraoperatve blood loss [(150.48±42.53) mL] was more than that of internal fixation group [(104.73±27.84) mL]， and the time in bed of artificial joint replacement group [(8.19±2.42) d] was shorter than that of internal fixation group [(11.58±3.13) d]， the differences were all statistically significant (all P < 0.05). The Harris hip scores of artificial joint replacement group at 3， 6， 12 months after operation were all higher than those of internal fixation group， while there were no statistically significant differences (P > 0.05). Followed-up for 1 year after operation， the incidence of complications in artificial joint replacement group (16.67%) was lower than that of internal fixation group (29.79%)， the difference was statistically significant (P < 0.05). Conclusion Artificial joint replacement and internal fixation in the treatment of elderly patients with intertrochanteric fracture has merits and demerits respectively， so the preoperative assessment is very important， it is necessary to take different surgical methods according to the specific situations of patients， so as to improve the hip joint function and prognosis. (刘向春 李春根 叶超 李鹏洋)
[关键词] 人工关节置换术；内固定术；股骨转子间骨折；老年；效果
[中图分类号] R687.3 [文献标识码] A [文章编号] 1673-7210(2016)06(c)-0101-04
[Abstract] Objective To compare the effect of artificial joint replacement and internal fixation in the treatment of elderly patients with intertrochanteric fracture. Methods The clinical data of 83 cases with intertrochanteric fracture admitted to Dongzhimen Hospital， Beijing University of Chinese Medicine from January 2013 to January 2015 was analyzed retrospectively. The patients were divided into artificial joint replacement group (36 cases) and internal fixation group (47 cases) according to different surgical methods. The operation time， intraoperatve blood loss and the time in bed of the two groups were compared； the Harris hip scores of the two groups at 3， 6， 12 months after operation were recorded； the complication after operation for 1 year of the two groups were analyzed. Results The operation time[(85.37±20.18) h] of artificial joint replacement group was longer than that of internal fixation group [(69.28±17.51) h]， the intraoperatve blood loss [(150.48±42.53) mL] was more than that of internal fixation group [(104.73±27.84) mL]， and the time in bed of artificial joint replacement group [(8.19±2.42) d] was shorter than that of internal fixation group [(11.58±3.13) d]， the differences were all statistically significant (all P < 0.05). The Harris hip scores of artificial joint replacement group at 3， 6， 12 months after operation were all higher than those of internal fixation group， while there were no statistically significant differences (P > 0.05). Followed-up for 1 year after operation， the incidence of complications in artificial joint replacement group (16.67%) was lower than that of internal fixation group (29.79%)， the difference was statistically significant (P < 0.05). Conclusion Artificial joint replacement and internal fixation in the treatment of elderly patients with intertrochanteric fracture has merits and demerits respectively， so the preoperative assessment is very important， it is necessary to take different surgical methods according to the specific situations of patients， so as to improve the hip joint function and prognosis. (刘向春 李春根 叶超 李鹏洋)