两种治疗方法治疗老年股骨粗隆间骨折的疗效分析

Treatment of femoral intertrochanteric fracture in elder patients with two therapeutic methods

目的探讨手术疗法及非手术疗法治疗老年股骨粗隆间骨折的临床疗效及临床适应证。方法 84例老年股骨粗隆间骨折患者中,其中非手术治疗21例,手术治疗63例。结果与非手术组相比,手术组术后并发症发生率低,住院期间死亡率低;手术组死亡率为1.6%,并发症发生率为9.58%,非手术组死亡率为9.5%,并发症发生率为23.8%,两组间有显著性差异(P<0.05);经6个月至3年的随访,手术组优良率为91.9%,非手术组优良率为89.9%,两组间无显著性差异(P>0.05)。结论对老年股骨粗隆间骨折应根据骨折类型、年龄、体质因素及骨质疏松程度等作综合分析,手术治疗为首选的治疗方法。

Objective To study the clinical effect and indications of operative approach and non-operative approach in treatment of elder patients with femoral intertrochanteric fracture.Methods Altogether 84 elder cases of intertrochanteric fracture including 21 cases treated with non-operative method and 63 cases with operative method were studied and compared.Results Post-operative complication and hospitalized mortality of operation group were lower than those of non-operation group. 1.6% operative mortality and complication rate was 9.58%, non-operative mortality was 9.5%, complication rate was 23.8%, between the two groups was significant difference （P0.05）. All patients were followed up for 6 months to 3 years, the result of follow-up survey demonstrated that excellent rate of patients in operation group was 91.9% and that of patients in non-operation group was 89.9%. There was no significant statistical difference between these two groups （P0.05）.Conclusion Clinical treatment should be performed according to general analysis of types of bone fracture, age, physical factors and the degree of looseness of fractured bone etc, and operation would be the first choice for treatment of femoral intertrochanteric fracture in elder patients.