高龄股骨颈骨折人工关节置换的围手术期处理

Perioperative management of prosthetic replacement in elder patients with femoral neck fracture

目的:对行人工关节置换手术的高龄股骨颈骨折患者进行围手术期综合处理,探讨其围手术期治疗的必要性与重要性。方法:68例股骨颈骨折的高龄患者,男28例,女40例;年龄70～88岁,平均76.4岁。所有患者于关节置换术前采用有效的降糖,降压,营养心肌,保肝,纠正贫血、低蛋白血症等综合处理,控制合并症。患者全身情况、脏器功能状况可耐受手术后行人工关节置换手术。结果:所有患者均安全渡过手术期,切口Ⅰ期愈合。1例术后早期出现腹泻并发症,经应用制霉菌素及金双岐调节肠道菌群,腹泻控制。按Harris标准评价疗效,优39例,良24例,可5例,优良率92.6%。结论:严格有效的围手术期综合治疗是处理高龄股骨颈骨折患者行人工关节置换手术的安全保障。

Objective：To study the perioperative management and effects of prosthetic replacement in elder patient with femoral neck fracture. Methods：Among 68 elder patients with femoral neck fracture, 28 patients were male and 40 patients were female, with an average age of 76. 4 years ranging from 70 to 88 years. Before the operation the comprehensive treatment, including decreasing blood sugar and blood pressure, nourishing cardiac muscle, protecting liver, correcting hypohemia and hypoproteinemia, were given to all patients. When preoperative complication was controlled, the prosthetic replacement operation was performed. Results：All the patients underwent the operation safely, and the surgical incision healed in stage Ⅰ. One patient suffered from diarrhoea at early stage after operation, and healed after treatment with Nystatin. According to Harris evaluation criteria, excellent result reached in 39 patients, good in 24 and fair in 5. The excellent and good rate was 92.6%. Conclusion：Effective perioperative management ensures successful prosthetic replacement operation in elder patients with femoral neck fracture.