高龄股骨颈骨折髋关节置换术的围术期治疗

目的 总结髋关节置换术治疗高龄股骨颈骨折患者的围手术期治疗方法及其效果. 方法 27例高龄股骨颈骨折患者采用全髋关节置换术12例,人工股骨头置换术15例.所有患者重视围手术期治疗,包括术前全面评估患者全身情况;术中严密监护、缩短手术时间;术后加强合并疾病的治疗等. 结果 术后出现各种并发症16例,发生率59.3%.其中1例麻醉后发生心肌梗死致死亡,1例术后心律失常,4例患侧下肢深静脉血栓,4例尿路感染,3例肺部感染,2例合并尿路感染和肺部感染,1例合并下肢深静脉血栓和肺部感染.经加强围手术期治疗,26例全部治愈出院,髋关节活动功能良好. 结论 重视高龄股骨颈骨折髋关节置换术的围手术期治疗是手术成功的关键.

Perioperative treatment of senile patients with femoral neck fracture undergoing hip joint displacement

Objective To summerize the perioperative treatment methods and results of senile patients with femoral neck fracture undergoing hip joint displacement technique. Methods There were twenty-seven senile patients with femoral fracture, also suffered from other senile diseases. The hip joint displacement technique were adopted in twelve patients and femoral head prosthetic replacement in fifteen patients. The perioperative treatment of all the patients were highly valued, which consisted of evaluating the systemic conditions of patients before operation, monitoring patients＇ physical sign and curtailing operation time during operation, and paying much attention to the treatment of complicating diseases after operation. Results As a result, among the sixteen patients who suffered from complicating diseases after operation, one suffered from myocardial infarction after anaesthetization; one suffered from arrhythmia after operation; four suffered from vein thrombus of low limbs; four suffered urinary tract infection, three suffered pulmonary infection; two suffered both urinary tract infection and pulmonary infection; one suffered both vein thrombus of low limbs and pulmonary infection. Except one patient died from myocardial infarction after anaesthetization, the other twenty-six patients were recovered and discharged from hospital, the function of their hip joints were excellently recovered. Conclusion It＇ s crucial to value the perioperative treatment of senile patients with femoral neck fracture undergoing hip joint displacement in order to get the successful operation.