人工股骨头置换术与内固定在高龄骨质疏松股骨粗隆间骨折患者中的疗效

Therapeutic effects of artificial femoral head replacement and internal fixation on fracture of femurs haft due to osteoporosis in the elderly and its effects on incidence of complications of patients

目的探讨人工股骨头置换术与内固定在高龄骨质疏松股骨粗隆间骨折患者中的疗效及对患者并发症发生率的影响。方法选取收治的高龄骨质疏松股骨粗隆间骨折患者165例,按照手术方式分为A、B、C 3组,A组55例使用ALP手术方式,B组55例使用人工骨关节置换术,C组55例使用骨水泥PFNA手术方式。对比3组患者手术干预后各项指标、Harris评分及术后并发症状发生情况。结果 C组患者手术时间、失血量及愈合时间、住院时间明显低于A、B 2组患者(P<0.05);3组患者干预前Harris评分差异无统计学意义(P>0.05),干预后C组患者评分各项指标明显优于其他2组(P<0.05);C组患者术后并发症状低于其他2组(P<0.05)。结论高龄骨质疏松股骨粗隆间骨折患者治疗过程中,使用骨水泥PFNA手术时间短,术中出血量少,患者可快速恢复,术后并发症状明显减少,治疗效果理想,临床上应当进一步推广应用。

Objective To investigate the therapeutic effects of artificial femoral head replacement and internal fixation on fracture of femurs haft due to osteoporosis in the elderly and its effects on incidence of complications of patients.Methods A total of 165 elderly patients with fracture of femurs haft due to osteoporosis were enrolled in the study. Accoding to different surgical methods,these patients were divided into group A,group B and group C. The patients in group A were treated by ALP surgical method,and the patients in group B were treated by artificial joint replacement,moreover,the patients in group C were treated by bone cement PFNA operation method. After operation the therapeutic effects,Harris score and incidence rates of postoperative complications were observed and compared among the three groups. Results The operation time,intraoperative blood loss,healing time,length of hospital stay in group A were significantly lower than those in group A and group B（ P〈0. 05）. Before operation there were no significant differences in Harris scores among the three groups（ P〈0. 05）,however after operation Harris scores in group C were superior to those in the other two groups（ P〈0. 05）. Moreover,incidence rates of postoperative complications in group C were significantly lower than those in group A and group B（ P〈0. 05）. Conclusion The bone cement PFNA operation method in treatment of fracture of femurs haft due to osteoporosis in the elderly has the advantages of less operation time,less intraoperative blood loss,faster postoperative recovery,less postoperative complications,with satisfactory therappeutic effects,therefor,it should be used widely in clinical practice.