【摘要】 目的比较人工全髋关节置换术(THR)与钢板螺钉内固定术治疗老年股骨粗隆间骨折的临床效果。方法选取2012年6月至2015年6月深圳平乐骨伤科医院收治的老年股骨粗隆间骨折患者120例,按照手术方法分为观察组和对照组,每组60例。对照组患者给予钢板螺钉内固定术进行治疗,观察组患者给予THR治疗。对2组患者的手术时间、术中出血量、术后卧床时间、术后住院时间、术后髋关节功能Harris评分、临床疗效及术后并发症发生率进行比较。结果观察组患者的手术时间、术后卧床时间和住院时间显著短于对照组(P<0.05),术中出血量显著少于对照组(P<0.05),术后髋关节功能Harris评分显著高于对照组(P<0.05)。观察组和对照组患者治疗效果优良率分别为88.33%(53/60)、73.33%(44/60),观察组患者治疗效果优良率高于对照组(χ2=4.357,P<0.05)。观察组和对照组术后并发症发生率分别为5.00%(3/60)、40.00%(24/60),观察组患者并发症发生率显著低于对照组(χ2=21.075,P<0.05)。结论 THR治疗老年股骨粗隆间骨折具有手术时间短、术中出血量少、术后卧床和住院时间短、髋关节功能恢复好及并发症少等优势。更多还原

【Abstract】 Objective To compare the clinical effect of total hip replacement( THR) and plate-screw internal fixation in the treatment of elderly patients with intertrochanteric fracture. Methods A total of 120 elderly patients with intertrochanteric fracture were selected from June 2012 to June 2015 in Shenzhen Pingle Orthopedic Hospital. The patients were divided into observation group and control group according to surgical method,60 patients in each group. The patients in the control group were treated with plate and screw internal fixation,and the patients in the observation group were treated with THR. The operation time,intraoperative blood loss,postoperative bed rest time,hospitalization time,Harris score of hip function,clinical effect and postoperative complication rate were compared between the two groups. Results The operation time,postoperative bed rest time and hospitalization time in the observation group were significantly shorter than those in the control group( P < 0. 05),and the intraoperative blood loss in the observation group was significantly less than that in the control group( P < 0. 05),and the Harris score of hip function in the observation group was significantly higher than that in the control group( P < 0. 05). The fineness rate in the observation group and control group was 88. 33%( 53/60) and 73. 33%( 44/60) respectively,the fineness rate in the observation group was higher than that in the control group( χ~2= 4. 357,P < 0. 05). The incidence of postoperative complication in the observation group and control group was 5. 00%( 3/60) and 40. 00%( 24/60),the incidence of postoperative complication in the observation group was significantly lower than that in the control group( χ~2= 21. 075,P < 0. 05).Conclusion THR in the treatment of intertrochanteric fracture in elderly patients has the advantages of shorter operation time,less intraoperative blood loss,shorter postoperative bed rest time and hospitalization time,good hip function recovery and less complications.更多还原