49例老年髋部骨折患者的手术治疗及预后评估研究

Surgical treatment and prognosis evaluation of 49 elderly patients with hip fracture

目的探讨老年髋部骨折患者的手术治疗效果及预后情况.方法选择我院2017年3月~2018年9月收治的98例患者随机分为观察组(n=49)和对照组(n=49).对照组患者给予常规保守牵引治疗,观察组给予手术治疗.观察比较两组临床疗效、髋关节功能Harris评分及术后并发症发生情况.结果观察组优良率为89.80%高于对照组的79.59%,但差异无统计学意义(χ^2=1.968,P=0.161);两组疗效整体比较,差异有统计学意义(Z=-6.928,P=0.000).治疗后,两组Harris评分与治疗前比较均显著升高,差异有统计学意义(t=-18.663,P=0.000;t=-15.682,P=0.000);且治疗后观察组Harris评分(88.47±15.84)分显著高于对照组(81.36±12.56)分,差异有统计学意义(t=2.462,P=0.016).观察组术后并发症发生率4.08%显著低于对照组的16.33%,差异有统计学意义(χ^2=4.009,P=0.045).结论手术治疗老年髋部骨折临床疗效显著,可有效改善患者髋关节功能,减少并发症,提高患者生活自理能力及生活质量,值得推广应用.

Objective To investigate the surgical treatment effect and prognosis of elderly patients with hip fracture. Methods 98 patients admitted in our hospital from March 2017 to September 2018 were randomly divided into observation group(n=49) and control group(n=49). Patients in the control group were given conventional conservative traction therapy and the observation group was given surgery. The clinical efficacy, hip function Harris score and postoperative complications were compared between the two groups. Results The excellent and good rate of the observation group was 89.80%, higher than that of the control group(79.59%). There was no significant difference between the two groups(χ^2=1.968, P=0.161). There was a statistically significant difference in the overall effect between the two groups(Z=-6.928, P=0.000). After treatment, the Harris scores of the two groups were significantly higher than those before treatment, and the difference was statistically significant(t=-18.663, P=0.000;t=-15.682, P=0.000). And the Harris score of the observation group was 88.47±15.84 after treatment, significantly higher than(81.36±12.56) of the control group, and the difference was statistically significant(t=2.462, P=0.016). The postoperative complication rate of the observation group was 4.08%, significantly lower than that of the control group(6.33%), and the difference was statistically significant(χ^2=4.009, P=0.045). Conclusion Surgical treatment of elderly hip fracture has a significant clinical effect, which can effectively improve hip function, reduce complications, improve patient self-care ability and quality of life, and is worthy of popularization and application.