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老年股骨粗隆間骨折的內(nèi)固定治療及并發(fā)癥分析和手術(shù)危險(xiǎn)性預(yù)測(cè)
作者：曾劍文，謝文，朱錦宇，邊子虎，韓一生，朱慶生【關(guān)鍵詞】 ,髖骨折
Complications and highrisk factors of internal fixation in elderly patients with intertrochanteric femoral fracture
【Abstract】 AIM: To compare the postoperative functional restoration and complication incidence of different therapies in elderly patients with intertrochanteric femoral fracture and to predict the highrisk factors of the operation. METHODS: One hundred and sixtyeight cases of elderly patients with intertrochanteric femoral fractures, who were treated from March, 1995 to June, 2001 were enrolled in the study. Of all the cases, 136 cases received internal fixation therapy and 83 cases were followed up for an average of 37.8 months. According to operative approach, types of fractures and age, the patients were divided into several groups and the therapeutic effects and complications were compared. By calculating composite exponent W of operation risks and mean ages of patients with complications (especially at early stage after operation), the prediction of the operation risk was made. RESULTS: Of the 83 cases, 67 (80.7%) had good functional restoration. Of the 10 (12.0%) cases with complications after operation, 3 cases suffered complications at early stage after operation. The duration and bleeding volume of operation in dynamic hip screw (DHS) internal fixation group were more than those in the other groups (P＜0.05). Hospitalization time in intramedullary pin internal fixation group was shorter than that in the other groups. Patients in the group of ages above 70 years had a bad functional restoration. Complication incidence between every two groups had no statistical significance. The average age in the 10 cases with complications was 82 years old. The mean age of 3 cases with early complications was 92 years old, whose exponent W was 6, 7 and 8 respectively. CONCLUSION: Suitable internal fixation materials should be chosen in the therapy of elderly patients with intertrochanteric femoral fractures. DHS, multipin, especially intramedullary pin, can satisfy the needs of fractures of various types for all ages. Age may be a high risk factor in the therapy of elderly patients with intertrochanteric femoral fracture.
【Keywords】 hip fractures; aged; internal fixation; postoperative complication; risk factors
【摘要】 目的： 比較不同內(nèi)固定方法治療老年股骨粗隆間骨折的療效,并發(fā)癥發(fā)生原因并預(yù)測(cè)手術(shù)危險(xiǎn)的高危因素. 方法： 199503/200106收治60歲以上老年股骨粗隆間骨折患者168例. 行手術(shù)內(nèi)固定治療136例，83例獲得12~75（平均37.8） mo的隨訪，通過病歷分析獲得年齡、性別、骨折類型、手術(shù)方式、手術(shù)時(shí)間、住院天數(shù)、術(shù)中出血量、是否輸血以及輸血量、傷前生活自理能力、傷前身體狀況、術(shù)前血紅蛋白（Hb）水平、功能恢復(fù)及并發(fā)癥發(fā)生情況，分別按手術(shù)方式、骨折類型以及年齡分組比較其療效和并發(fā)癥發(fā)生情況，通過計(jì)算發(fā)生并發(fā)癥（尤其是術(shù)后早期并發(fā)癥）患者的平均年齡和手術(shù)危險(xiǎn)性預(yù)測(cè)綜合指數(shù)W值，預(yù)測(cè)手術(shù)危險(xiǎn)的高危因素. 結(jié)果： 本組83例，術(shù)后功能恢復(fù)優(yōu)良67例，可9例，差7例；優(yōu)良率80.7%. 術(shù)后發(fā)生并發(fā)癥10例，平均年齡為82歲，發(fā)生率12.0%，術(shù)后早期誘發(fā)原有合并癥3例,平均年齡為92歲. 動(dòng)力髖內(nèi)固定組的手術(shù)時(shí)間比其他兩組明顯延長(zhǎng)（P＜0.05）；術(shù)中出血以及輸血量比其他兩組明顯增多；髓內(nèi)釘內(nèi)固定組住院天數(shù)比其他兩組明顯縮短；年齡大于70歲組功能恢復(fù)較差；以上比較均有統(tǒng)計(jì)學(xué)意義. 各組并發(fā)癥發(fā)生比較無顯著性差異. 早期誘發(fā)原有合并癥的3例患者，手術(shù)危險(xiǎn)性預(yù)測(cè)綜
【老年股骨粗隆間骨折的內(nèi)固定治療及并發(fā)癥分析和手術(shù)危險(xiǎn)性預(yù)測(cè)】相關(guān)文章：
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