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| 高龄股骨转子间骨折人工股骨头置换 及围术期特点 |
| Femoral intertrochanteric fractures in the elderly with artificial femoral head replacement and perioperative characteristics |
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| DOI： |
| 中文关键词: 转子间骨折 骨质疏松 并发症 围术期 股骨头置换 |
| 英文关键词:Intertrochanteric fracture 0 steoporosis C omplication Perioperative period Femoral head volu e change |
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| 中文摘要: |
| 目的探讨高龄骨质疏松性股骨转子间骨折行人工股骨头置换及围术期特点。方法通过对 31例高龄骨质疏松性股骨转子间新鲜骨折，年龄75耀93岁，平均82.5岁。对骨质疏松行sh!gh指数 分级II级23例，III级8例，均行人工股骨头置换术。对围术期特点、治疗、康复锻炼及微创手术进 行回顾性分析。结果31例患者均获随访，随访时间12耀47个月，平均17.5个月。平均手术时间 86 min，平均术中出血450 ml。11例（35.5% )患者术后出现新的并发症，其中心血管系统的并发症 (低血压、心功能不全、房颤）最多，为16%_( 5例）。肺部感染者6. 5%_( 2例）。低Cl—、低K+、低蛋白 血症者13%_( 4例）。Harris髋关节功能评分，优15例、良10例、可5例、差1例。优良率80. 6%_。结 论高龄转子间骨折患者合併多种内科疾病，存在骨质疏松，行人工股骨头置术，手术风险高，成功的 关键在于充分围术期准备、微创操作，缩短手术时间。早期主被动功能锻炼及抗骨质疏松处理。 |
| 英文摘要: |
| Objective Senile osteoporotic remorai intertrochanteric fractures with artificial femoral head repiacement and perioperative characteristics. Methods 31 cases of senile osteoporotic inLertrochanteric fresh fracLure， age 75 - 93 years old， average 82. 5 years old. On Lhe osLeoporosis Singh index grade II 23 cases， III 8 cases， underwent artificial femoral head replacement. On perioperative characteristics， treatment，rehabilitaLion Lraining and minimaUy invasive operation were reLrospecLively analyzed. Results 31 cases were foUowed up，follow-up time 12-47 months， an average of 17. 5 months. The average operation time of 86min，mean inLraoperative bleeding of 450ml. In 11 cases ( 35. 5%. ) patients after the appearance of new complications， including cardiovascular system complication ( hypoLension， heart failure， aLrial fibrillation ) up to 16%. ( 5 cases ). Pulmonary infection in 6.5%. ( 2 cases ). tow Cl， hypoalbuminemia in 13%' ( 4 cases ). The Harris hip score， 15 cases were excellent， good in 9 cases， in 5 cases，poor in 1 cases. The excellenL and good rate was 77. 5% . Conclusion the intertrochanLeric fracture in the elderly with multiple internal medicine disease osLeoporosis， arLificial femoral head in Lhe operaLion， high risk， the key to success is full of perioperaLive preparaLion，minmially invasive operaLion， shorLen Lhe operation time. Early passive funcLional exercise and osteoporosis treaLment. |
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