人工关节置换术对老年股骨粗隆间骨折患者Harris评分和预后的影响

Effect of Artificial Joint Replacement on Fracture Harris Score and Prognosis of Femoral Intertrochanteric Fracture for Elderly Patients

目的:进一步探讨人工关节置换术对老年股骨粗隆间骨折Harris评分和预后的临床影响,为临床实践提供借鉴和参考依据。方法:选取我院骨科近三年临床收治的老年股骨粗隆间骨折患者226例,按照患者手术方式将其分成研究组和对照组,每组113例。分别给予患者内固定术和人工关节置换术治疗,对两组患者前术后疼痛评分、术后6个月和12个月的Harris评分以及术后并发症发生情况进行观察和比较。结果:(1)术前两组患者疼痛评分差异不大,且无统计学意义;术后3周和3个月的疼痛评分组间比较,研究组均低于对照组,且差异有统计学意义;(2)研究组术后6个月和12个月的Harris评分结果的优良率水平显著高于对照组,且差异有统计学意义;(3)研究组患者并发症发生率显著低于对照组。结论:人工关节置换术能够显著改善老年股骨粗隆间骨折Harris评分提高患者临床预后,是临床治疗老年股骨粗隆间骨折的理想手术方式之一。

Objective： To further explore the clinical effect of artificial joint replacement on Harris score and prognosis of aged femoral intertrochanteric fractures, and to provide reference for clinical practice. Methods： 226 patients with intertrochanteric fractures in the department of orthopedics of our hospital from December 2014 to November 2016 were enrolled. According to surgical methods, they were divided into the study group and the control group, and 113 cases in each group. The patients were taken with internal fixation and artificial joint replacement surgery. The incidence of postoperative pain, Harris score 6 months and 12 months after the surgery and postoperative complications were observed and compared between the two groups. Results： （1） There was no significant differences in pain score between the two groups before operation and there were no statistical significance. Regarding the pain scores 3 weeks and 3 months after operation, the study group was lower than the control group, and the differences were statistically significant. （2） The level of Harris score 6 months and 12 months after operation was significantly higher than that of control group, and the differences were statistically significant. （3） The incidence of complications in study group was significantly lower than the control group, and the differences were statistically significant. Conclusion： Artificial joint replacement can improve the clinical prognosis of elderly patients with intertrochanteric fractures, which is one of the ideal surgical methods for the treatment of intertrochanteric fractures in the elderly patients.