85岁以上老年人髋部骨折围手术期治疗

Perioperative treatment for hip fracture beyond 85 years of age

目的：探讨老年人髋部骨折围手术期治疗。方法：1999年9月-2006年1月治疗85岁以上老年人髋部骨折68例，男31例，女37例；年龄85～93岁，平均87岁；左髋31例，右髋37例。有60例存在一种以上的并存症。人工股骨头置换术28例，加压空心钉固定21例，动力髋固定19例。术前应积极治疗并存疾病，手术采用硬膜外麻醉，尽力缩短手术时间，术后加强护理。结果：68例中术中休克1例，术后由于消化道出血死亡1例，所有患者围手术期切口无感染。结论：对于85岁以上老年患者髋部骨折，只要术前准备充分，术中尽力缩短手术时间，术后加强护理，是能度过围手术期的。

Objective： To explore perioperative treatment for hip fracture beyond 85 years of age. Methods： From September 1999 to January 2006,68 patients with hip fracture were treated with femoral head replacement （28 cases）, hollow compressive screw fixation （21 cases） and dynamic hip screw fixation （ 19 cases）, including 31 male and 37 female with the mean age of 87 years （from 85 to 93）. Thirty-one cases were left and 37 cases were right. Results： Sixty cases had one intercurrent desease which were treated before operation and epidural anesthesia was used during operation. Operative time was shorten as far as possible and intensive nursing was given after operation. Conclusion： The aged patients （above 85 years） with hip fracture can live through perioperation successfully with full preparation before operation and intensive nursing after operation.