[1]段军富,王　博,李云靖,等.半髋关节置换术与股骨髓内钉固定术治疗老年股骨粗隆间骨折疗效比较[J].新乡医学院学报,2017,34(4):300-302.[doi:10.7683/xxyxyxb.2017.04.014]
　DUAN Jun-fu,WANG Bo,LI Yun-jing,et al.Comparison of the effect of hemiarthroplasty and femoral intramedullary nail fixation for the treatment of intertrochanteric fracture in elderly patients[J].Journal of Xinxiang Medical University,2017,34(4):300-302.[doi:10.7683/xxyxyxb.2017.04.014]
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半髋关节置换术与股骨髓内钉固定术治疗老年股骨粗隆间骨折疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年4
页码:
300-302
栏目:
临床研究
出版日期:
2017-04-05

文章信息/Info

Title:
Comparison of the effect of hemiarthroplasty and femoral intramedullary nail fixation for the treatment of intertrochanteric fracture in elderly patients
作者:
段军富1; 王　博1; 李云靖1; 付军振1; 张红敏2
（1.鹤壁市人民医院创伤及关节骨科，河南　鹤壁　458030；2.鹤壁市淇滨区人民检察院技术科，河南　鹤壁　458030）
Author(s):
DUAN Jun-fu1; WANG Bo1; LI Yun-jing1; FU Jun-zhen1; ZHANG Hong-min2
（1.Department of Osteology，the People′s Hospital of Hebi City，Hebi 458030，Henan Province，China；2.Department of Technology，the People′s Procuratorate of Qibin District of Hebi City，Hebi 458030，Henan Province，China）
关键词:
股骨粗隆间骨折; 半髋关节置换术; 股骨髓内钉
Keywords:
intertrochanteric fracture; hemiarthroplasty; femoral intramedullary nail
分类号:
R687.3
DOI:
10.7683/xxyxyxb.2017.04.014
文献标志码:
A
摘要:
目的　比较半髋关节置换术与股骨髓内钉固定术治疗老年股骨粗隆间骨折的临床效果及安全性。方法　选择2012年1月至2015年1月鹤壁市人民医院收治的老年股骨粗隆间骨折患者46例，根据治疗方法分为髓内钉组和半髋关节置换组，每组23例，髓内钉组患者采用股骨髓内钉固定术治疗，半髋关节置换组患者采用半髋关节置换术治疗，对2组患者治疗效果及安全性进行比较。结果　半髋关节置换组患者手术时间、术后卧床时间、住院时间显著短于髓内钉组（P<0.05），术中出血量显著少于髓内钉组（P<0.01）。术后1个月，半髋关节置换组和髓内钉组患者髋关节功能评分分别为81.29±4.75和72.44±4.18，半髋关节置换组患者髋关节功能评分高于髓内钉组（P<0.05）。半髋关节置换组和髓内钉组患者治疗效果优良率分别为95.65%（22/23）和73.91%（17/23），半髋关节置换组患者治疗效果优良率显著高于髓内钉组（P<0.05）。半髋关节置换组和髓内钉组患者并发症发生率分别为13.04%（3/23）和17.39%（4/23），2组患者并发症发生率比较差异无统计学意义（P>0.05）。结论　半髋关节置换术与股骨髓内钉固定术治疗老年股骨粗隆间骨折安全性均良好，但行半髋关节置换术患者术中出血量少，手术时间、术后卧床时间和住院时间短，术后髋关节功能恢复快。
Abstract:
Objective　To compare the clinical efficacy and safety of hemiarthroplasty and femoral intramedullary nail fixation for the treatment of intertrochanteric fracture in elderly patients.Methods　Forty-six elderly patients with intertrochanteric fracture were selected in the People′s Hospital of Hebi City from January 2012 to January 2015.The patients were divided into intramedullary nail group and hemiarthroplasty group，23 cases in each group.The patients in the intramedullary nail group were treated with intramedullary nail fixation，and the patients in the hemiarthroplasty group were treated with hemiarthroplasty.The treatment effect and safety were compared between the two groups.Results　The operation time，postoperative sickbed time and hospitalization time in the hemiarthroplasty group were significantly shorter than those in the intramedullary nail group（P<0.05）；and the intraoperative blood loss in the hemiarthroplasty group was significantly less than that in the intramedullary nail group（P<0.01）.One month after operation，the hip joint function score in hemiarthroplasty group and intramedullary nail group was 81.29±4.75 and 72.44±4.18 respectively，the hip joint function score in hemiarthroplasty group was significantly higher than that in intramedullary nail group（P<0.05）.The fineness rate in hemiarthroplasty group and intramedullary nail group was 95.65%（22/23） and 73.91%（17/23） respectively，the fineness rate in hemiarthroplasty group was significantly higher than that in intramedullary nail group（P<0.05）.The incidence of complications in hemiarthroplasty group and intramedullary nail group was 13.04%（3/23） and 17.39%（4/23） respectively，there was no significant difference in the incidence of complications between the two groups（P>0.05）.Conclusion　The safety of hemiarthroplasty and femoral intramedullary nail fixation for the treatment of intertrochanteric fracture is good.However，hemiarthroplasty has the advantages of less intraoperative bleeding，shorter operation time，shorter postoperative sickbed time and hospitalization time，and faster postoperative recovery of hip joint function.

参考文献/References:

［1］　杨博，史宝明.动力髋螺钉与股骨近端髓内钉治疗老年股骨粗隆间骨折的疗效比较［J］.中国实用医刊，2015，42（23）：3-4.
［2］　邵锋，卢绪章.髓外固定与髓内固定治疗股骨转子间骨折疗效比较［J］.新乡医学院学报，2015，32（7）：663-665.
［3］　张景林，刘晓龙，杨树玲.高龄股骨粗隆间骨折人工股骨头置换的临床应用评价［J］.山东医药，2014，54（17）：70-72.
［4］　陈新宇.PFNA与DHS治疗超高龄股骨粗隆间骨折的疗效分析［J］.实用医学杂志，2015，31（12）：1993-1995.
［5］　马晓程，杨彬，谢鸣.股骨近端抗旋髓内钉与动力髋螺钉治疗高龄股骨粗隆间骨折的疗效对比研究［J］.中国医药导刊，2014，16（1）：5-8.
［6］　MCCONNELL J，DILLON J，KINNINMONTH A，et al.Blood loss following total knee replacement is reduced when using computer-assisted versus standard methods［J］.Acta Orthopaedica Belgica，2012，78（1）：75-79.
［7］　陈晋伟，杜张荣，田少斌，等.股骨近端髓内钉螺旋刀治疗股骨粗隆间骨折临床分析［J］.中国实用医刊，2015，42（12）：25-26.
［8］　王申宇，徐南伟，黄勇.防旋型股骨近端髓内钉与动力髋螺钉治疗高龄股骨粗隆间骨折的疗效比较［J］.实用临床医药杂志，2014，18（16）：67-74.
［9］　KOKOROGHIANNIS C，AKTSELIS I，DELIGEORGIS A，et al.Evolving concepts of stability and intramedul ary fixation of in-tertrochanteric fractures：a review［J］.Injury，2012，43（6）：686-693.
［10］　钱涛，夏永法，项杰，等.加长柄人工髋关节假体置换治疗高龄股骨粗隆间骨折的疗效观察［J］.浙江中医药大学学报，2014，38（5）：605-607.

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更新日期/Last Update: 2017-04-05