PFN内固定与人工股骨头置换术治疗老年股骨粗隆间骨折临床研究(1)
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[摘要] 目的 评价PFN内固定与人工股骨头置换治疗老年股骨粗隆间骨折疗效的比较。 方法 本组患者共66例，分为PFN内固定组(A组)和人工股骨头置换组(B组)，两组均采用常规手术入路。观察两组患者的手术时间、出血量、住院费用、术后下地负重时间、髋关节功能及并发症等指标。 结果 66例股骨粗隆间骨折患者经手术治疗均获得成功。两组并发症发生率比较，差异无统计学意义(P > 0.05)。B组手术时间少于A组，术中出血量、住院费用多于A组，且B组术后下地负重时间早于A组(均P < 0.01)。B组术后髋关节Harris评分优于A组(P < 0.05)。 结论 两组手术方式均有一定的疗效，需严格掌握手术适应证、禁忌证和术中操作技巧。
[关键词] 股骨粗隆间骨折；PFN内固定；人工股骨头置换
[中图分类号] R683.42 [文献标识码] A [文章编号] 1673-7210(2012)01(b)-043-02
Clinical study of PFN fixation and hemiarthroplasty in the treatment of intertrochanteric femoral fractures in elder patients
LI Haiyan
Department of Orthopedic, Jingmen Duodao People's Hospital, Hubei Province, Jingmen 448124, China
[Abstract] Objective To evaluate and compare the therapeutic efficacy of PFN fixation and hemiarthroplasty in the treatment of elderly patients with intertrochanteric fracture. Methods 66 patients were divided into PFN fixation group (group A) and the hemiarthroplasty group (group B) and conventional surgical approach were adopted in both groups. Surgical time, blood loss, hospital costs, weight-bearing ambulation after surgery, hip function and complications were observed. Results Surgical treatment was successful in all the 66 cases of intertrochanteric fractures patients. There was no significant difference of complication between the two groups (P > 0.05). There were significantly less operative time, more blood loss and hospital costs in group B, and time before weight-bearing ambulation after surgery was significantly shorter in group B (all P < 0.01). Postoperative Harris hip score of group B was better than that of group A (P < 0.05). Conclusion Two surgical procedures are effective to some degree, and strict control of surgical indications, contraindications and operating skills is critical.
[Key words] Intertrochanteric fractures; PFN fixation; Hemiarthroplasty
股骨粗隆间骨折是老年人髋部常见骨折，常被称为“终末骨折”，死亡率较高，资料显示[1]，20%的患者在股骨粗隆间骨折后1年内死亡。积极主动的手术治疗和恰当的手术方式成为挽救生命的关键。本文对我院2006年4月~2009年8月收治的66例老年股骨粗隆间骨折患者进行回顾性研究，现报道如下：
1 资料与方法
1.1 一般资料
选取我院2006年4月~2009年8月收治的老年股骨粗隆间骨折患者66例，采用PFN(A组)手术治疗32例，其中，男17例，女15例；年龄60~88岁，平均73 ......
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