手术治疗与保守治疗对老年髋臼骨折患者的疗效比较

Comparison of the Clinical Effect of Surgery and Conservative Therapy on the Elderly Patients with Acetabular Fractures

目的:比较手术治疗与保守治疗对老年人髋臼骨折患者的临床疗效。方法:选取我院2014年2月至2017年2月收治的老年髋臼骨折患者86例,所有患者均符合手术适应证,结合患者意愿,分为保守治疗组及手术治疗组。保守治疗组采用持续骨牵引治疗,手术治疗组采用切开复位内固定术。对两组患者进行随访,比较两组患者肺部感染、褥疮、深静脉血栓、泌尿系感染的持续时间及发生率,根据Harris标准对两组患者患髋功能进行评定,比较优良率。参考Matta标准对骨折复位情况进行比较。结果:手术治疗组肺部感染、褥疮、深静脉血栓、泌尿系感染的持续时间及发生率明显短于或低于保守治疗组(P<0.05)。保守治疗组患者患髋功能按Harris标准进行评分,得分62-95分,平均80分;手术组患者患髋功能按Harris标准进行评分,得分82-98分,平均91分,显著高于保守治疗组(P<0.05)。按Harris标准进行评定,手术治疗组患者的优良率高于保守治疗组(P<0.05)。参考Matta标准,手术治疗组患者的骨折复位情况优于保守治疗组(P<0.05)。结论:对于老年人髋臼骨折,手术治疗临床疗效及安全性均明显优于保守治疗。

Objective： To compare the clinical effect of surgery and conservative therapy on the elderly patients with acetabular fractures. Methods： 86 cases of elderly patients with acetabular fractures in our hospital from February 2015 to February 2017 were selected. All the patients had surgical indication, combined with the wishes of patients, who were divided into the conservative group and the operative group. The conservative group was treated with continuous skeletal traction, and the operative group was treated with open reduction and internal fixation. Both groups were followed up. The duration and incidence of pulmonary infection, bedsore, deep vein thrombosis and urinary system infection were compared between two groups. According to the Harris standard, the function of hip of pa- tients were evaluated, and the superior rate was compared. According to Matta standard, the fracture reduction was compared. Results： The duration and incidence of pulmonary infection, bedsore, deep vein thrombosis and urinary system infection in the operative group were significantly shorter or lower than those of the conservative group. According to the Harris standard, the patients in the conservative group scored a 62-95 points, average scores were 80, the patients in the operative group scored a 82-98 points, average scores were 91. The average score of operative group was higher than that of the conservative group. According to the Harris standard, the superior rate in the operative group was higher than that in the conservative group. According to Matta standard, the fracture reduction in the operative group was superior to that in the conservative group. Conclusion： Surgery was better than conservative therapy for the elderly patients with acetabular fractures.