老年股骨颈骨折围手术期的中西医结合治疗研究

Treatment of Senile Femoral Neck Fracture During Perioperative Period with Traditional Chinese Medicine and Western Medicine

【目的】探讨老年股骨颈骨折患者围手术期的中西医结合治疗方法。【方法】回顾性分析59例股骨颈骨折行手术治疗的老年患者的围手术期资料,根据患者术后并发症、患者主诉、关节功能及X线摄片等评价中西医结合治疗效果。【结果】全部患者根据临床实际分别采用AO空心加压螺钉内固定、人工股骨头置换和人工全髋关节置换术3种手术方法;术前55例合并内科合并症,其中以心血管系统疾患最为常见;术后除1例发生髋关节假体脱位,诱发心力衰竭加重而致死亡外,全部病例均未发生术口感染、下肢血管栓塞、脑血管意外、心梗、肺栓塞等常见并发症,均顺利出院。【结论】积极的围手术期评估和中西医结合处理是老年股骨颈骨折患者手术治疗成功的主要措施之一。

Objective To evaluate the therapeutic effect of traditional Chinese medicine and western medicine（TCM-WM） for the treatment of senile femoral neck fracture（SFNF） during perioperative period.Methods A retrospective analysis was carried out in 59 patients.Perioperative clinical data of SFNF patients admitted in orthopedics department of the second affiliated hospital,Guangzhou University of TCM were collected and analyzed.Postoperative complications,chief complaints,joint function and X-ray examination results were used to evaluate the effect of perioperative treatment.Results The patients received AO cannulated screw fixation,artificial femoral head replacement and total artificial hip joint replacement according to the classification of SFNF.Before theoperation,55 patients suffered from internal medical complications,in particular the cardiovascular diseases.After operation,one patient had dislocation of artificial hip joint and then died of deterioration of heart failure.Neither of the other patients suffered from infection of operative wound,vascular embolism of lower limbs,cerebrovascular accident,myocardial infarction,or pulmonary embolism.The 58 patients finally discharged successfully.Conclusion Active perioperative evaluation and treatment are the important measures to ensure the success of operation for the SFNF.