老年髋部骨折术后早期并发症对疗效的影响

[目的]分析老年髋部骨折患者术后心肺及血液系统早期并发症对手术疗效的影响。[方法]研究2001年1月-2005年7月本科收治的59例髋部骨折，其中39例合并有内科疾病，多为高血压、慢性支气管炎、糖尿病、心律失常。共有56例行手术治疗。[结果]52例均手术成功，1例死亡。死亡原因为肺间质纤维化。术后呼吸道、泌尿系、伤口感染、褥疮、应激性溃疡和下肢深静脉血栓的发生率分别为19％、10％、8％、5％、2％和4％。[结论]老年髋部骨折病人术后肺部感染的发病率最高，术前应评价心肺功能。下肢深静脉血栓是最严重的并发症，术后应早期开始股四头肌功能锻炼，并适时应用抗凝剂，同时辅助行CPM机锻练。手术方式的选择也是影响疗效的一个重要因素。

Influence of operative effect from postoperative early complication in elderly patients with hip fractures

[ Objective ] To analyze the influence of operation effect from complication of cardiac, pulmanary and hematology system in elder patients with hip fracture. [ Method] Fifty-nine cases with hip fracture from Jan. 2001 to Jul. 2005 were admitted in the department. Thirty-nine patients were acomplicated with medical diseases, most of them were hypertension,chronic bronchitis and diabetes mellitus. Among these patients,56 cases were operated. [ Result] Fifty-two cases were operated successfully. One died of pulmonary interstitial fibrosis. The incidence of postoperative complications, including infection of pulmonary, urinary and wound, bedsore,irritable allergic ulcer and lower extremities venous thrombosis were 19%, 10%, 8%, 5%, 2% and 4% respectively. [ Conclusion] In elderly patients with hip fracture ,the incidence of pulmonary infection is the highest. The lower extremities venous thrombosis is the most serious complication. So it is helpful to do quadriceps femories function exercise. The operative method is also a very important cause to define the postoperative effect.