高龄髋部骨折手术治疗及围手术期并发症的研究

目的探讨高龄髋部骨折手术治疗及围手术期并发症的预防和处理方法。方法分析1998年1月至2006年10月39例高龄髋部骨折患者资料，合并其他部位骨折8例，合并内科严重疾病26例，手术内固定采用角状钢板、多枚斯氏钉、加压螺钉、动力髋螺钉（DHS）、Gamma钉、髋关节置换等，围手术期同时给予有效的内科合并症治疗。结果全部患者平均住院16d，住院期间无死亡病例。围手术期7例（18％）出现并发症，其中中枢神经系统（3例）和心血管系统（3例）并发症最高发，肺部感染1例。结论高龄髋部骨折患者内科合并症多而重，围手术期并发症多，预防措施是合并症与骨折的治疗应并重而有效，尽量选择快速麻醉及创伤小的手术方法。术前进行风险评估，充分准备，术后应给予认真对待，对其有可能出现的并发症应进行积极的预防和治疗是手术成功的重要因素。

Advanced Age Hip Fracture Operation Cures and Surrounds Operation Scheduled Time Complication

Objective To explore advanced age hip department bone fracture surgery treatment and encircles the surgery time illness complication the prevention and the processing method.Methods Thirty-nine examples from January,1998 to October,2006 advanced ages hip department bone fracture were retrospectively reviewed including the patient material,merged other bone fracture 8 examples,the merge internal medicine department serious disease 26 examples,in the surgery fixedly uses angle form the steel plate,many si sews,pressurizes the bolt,the power hip bolt(DHS),the Gamma nail,the coxa replacement and so on,encircled the surgery time simultaneously to give the effective internal medicine department merge sickness treatment.Results The complete patient equally was hospitalized for 16 days.Encircles the surgery time 7 examples(18%)to appear the illness complication:central nervous system(3 examples)and the cardiovascular system(3 examples) the illness complication high sends.The lung infects was 1 example.Conclusion Advanced age patient hip department,bone fracture internal medicine department merge sickness many and heavy,illness complication many.The preventive measure was the internal medicine department gets sick with the bone fracture treatment should pay equal attention to but was effective,chooses the wound small surgery,the fast anaesthesia and the surgery method as far as possible.In front of the technique carries on the risk the appraisal,the full preparation,after the technique should give the earnest treatment,has the illness complication to it which the possibility appears to be supposed to carry out the positive prevention and the treatment is the important attribute which the surgery succeeds.