人工股骨头置换治疗高龄股骨粗隆间不稳定骨折的疗效

【目的】探讨人工股骨头置换治疗高龄股骨粗隆间不稳定骨折的疗效。【方法】选择股骨粗隆间不稳定骨折高龄患者80例，随机分为两组，每组40例，观察组行人工股骨头置换手术治疗，对照组采用股骨近端锁定解剖钢板内固定治疗，两组患者术后经相同护理处理并定期随访观察，比较两组患者疗效及预后感染状况。【结果】两组手术时间、术中出血量比较无统计学差异(P >0.05)；观察组住院时间、术后下床时间及负重活动时间均显著性短于对照组，差异有统计学意义(P <0.05)；手术治疗6个月后，观察组患者髋关节功能 Harris 评分优良率为95.0%，显著性高于对照组(57.0%)(P <0.05)；观察组患者的术后感染率为20.0%，显著性低于对照组(35.0%)(P <0.05)；观察组褥疮、切口感染、尿路感染、肺部感染等各种感染并发率均显著性低于对照组(P <0.05)。【结论】人工股骨头置换治疗高龄股骨粗隆间不稳定骨折能有效提高临床疗效，提高高龄患者的生活质量，且预后感染状况相对良好，值得临床推广应用。

Clinical Effects of Femoral Head Replacement for Unstable Intertrochanteric Fractures of the Fe-mur in the Elderly

Objective]To evaluate the clinical effects and observe the prognosis infection of femoral head re-placement for unstable intertrochanteric fractures of the femur in the elderly.[Methods]80 elderly patients with unstable intertrochanteric fractures of the femur in our hospital were randomly divided into the observation group and control group,with 40 cases in each group.The observation group was given femoral head replacement while the control group was given dynamic hip screw fixation-both on the basis of the same general nursing and regular follow-ups.The clinical efficacy,prognosis and infection rates were compared between two groups.[Results]After general nursing,the average operation time and blood loss were not significantly different between the two groups (P >0.05).The average of length stay,bed time and weight-bearing activity time in the observation group were significantly shorter than the control group (P <0.05 ).Six months after surgery,the excellent treatment with Harris hip function score of the patients in the observation group was 95.0%,which was significantly higher than the 57% in the control (P <0.05);the postoperative infection rate in the observation group was 20.0%,which was significantly lower than in the control group (55.0%)(P <0.05).The bed sore,wound infections,urinary tract infections,lung infection,and other concurrent infections in the observation group were significantly lower than in the control group (P <0.05).[Conclusion]Artificial hip arthroplasty for unstable intertrochanteric frac-tures of the femur in the elderly can effectively improve clinical effects,the quality of life for elderly patients,and detect infections in a relatively reliable manner.It is worthy of further promotion and application.