股骨头置换治疗高龄股骨颈骨折及围手术处理

目的探讨人工股骨头置换治疗高龄股骨颈骨折患者疗效及围手术期处理。方法对40例高龄股骨颈骨折患者采用人工股骨头置换术治疗，加强围手术期风险评估及控制、术后并发症的防治。结果40例均获随访，时间6~12个月，患者髋关节功能恢复好，未发现髋内翻、感染、脱位。术后并发肺部感染4例、脑梗1例、深静脉栓塞2例、心力衰竭1例、死亡1例，并发症发生率为22％。结论高龄股骨颈骨折患者应用人工股骨头置换治疗虽然手术及麻醉风险较大，但积极治疗合并症，做好术前准备及风险评估，可使老年患者安全渡过麻醉及手术期并减少术后并发症，取得满意疗效。

Objective To study the artificial femoral head replacement treatment curative effect on femoral neck fracture in aged patients and perioperative management. Methods 40 elderly patients with femoral neck fractures were treated with artificial femoral head replacement. Perioperative risk assessment and control, prevention and treatment of postoperative complications were strengthened. Results All 40 patients were followed up for 6~12 months. The hip joint function recovered well without coxa vara, infection and dislocation. 4 cases were complicated with postoperative lung infection, 1 cases of cerebral infarction, deep vein thrombosis in 2 cases, 1 case of heart failure and death in 1 case, the incidence of complications was 22%. Conclusion The treatment of femoral neck fracture with artificial femoral head replacement has a great risk of operation and anesthesia, but active treatment of complication and preoperative preparation and risk assessment can make elderly patients safely pass through anesthesia and operation period and reduce postoperative complications, and achieve satisfactory results.