[1]黄鑫,苏柯,王晓宁,等.围手术期内科并存病对高龄股骨转子间骨折术后疗效的影响[J].中华老年骨科与康复电子杂志,2017,(01):11-16.[doi:10.3877/cma.j.issn.2096-0263.2017.01.003]
　Huang xin,Su Ke,Wang Xiaoning,et al.Influence of preoperative complications on the clinical outcome of elderly intertrochanteric fractures patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(01):11-16.[doi:10.3877/cma.j.issn.2096-0263.2017.01.003]
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围手术期内科并存病对高龄股骨转子间骨折术后疗效的影响()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年01期
页码:
11-16
栏目:
股骨骨折
出版日期:
2017-02-05

文章信息/Info

Title:
Influence of preoperative complications on the clinical outcome of elderly intertrochanteric fractures patients
作者:
黄鑫; 苏柯; 王晓宁; 朱颖波; 王金昌; 吴克俭; 刘亭茹
100048 北京，解放军总医院第一附属医院骨科
Author(s):
Huang xin;  Su Ke;  Wang Xiaoning;  Zhu Yingbo;  Wang Jinchang;  Wu Kejian;  Liu tingru
Orthopaedic Institute, the First Affiliate of General Hospital of PLA, Beijing 100048, China
关键词:
并存病;  骨折固定术; 内;  髋骨折;  骨钉;  治疗结果
Keywords:
Comorbidity;  Fracture fixation;  internal;  Hip fractures;  Bone nails;  Treatment outcome
DOI:
10.3877/cma.j.issn.2096-0263.2017.01.003
文献标志码:
A
摘要:
目的 探讨围手术期内科并存病对股骨近端防旋髓内钉（PFNA）内固定治疗高龄股骨转子间骨折患者疗效的影响。方法 回顾性分析 2012年 1月至 2015年 1月解放军总医院第一附属医院采用 PFNA治疗的 185例高龄股骨转子间骨折患者资料，根据围手术期是否有内科并存病分为有内科并存病组与无内科并存病组。随访并比较两组患者的围手术期失血量、疼痛、意识障碍、术后疗效及并发症发生情况。结果 185例患者获得满意随访，随访时间 10～46月，平均 28±5月。有内科并存病组的围手术期总失血量（1 125±107）ml，显著高于无内科并存病组（938±76）ml，差异有统计学意义（t=18.436， P＜0.05）。有内科并存病组 Harris 髋关节评分为（74.2±2.9）分，优良率为 75.0%；无内科并存病组为（85.6±2.3）分，优良率为 91.9%，差异有统计学意义（U=3.124，P＜0.05）。有内科并存病组术后并发症发生率为 19.6%（29/148），显著高于无内科并存病组 5.4%（2/37，c2=4.580，P＜0.05）。有内科并存病组术后 Glasgow评分（[ 9.2±2.5）分]低于无内科并存病组（[ 11.3±3.4）分；t=18.635，P＜0.05]。两组术后 VAS评分比较，差异无统计学意义。结论 内科并存病是影响 PFNA内固定治疗高龄股骨转子间骨折患者疗效的重要因素。
Abstract:
Objective To investigate the possible affect of preoperative complications on PFNA fixation efficacy in elderly patients with intertrochanteric fractures. Methods A retrospective analysis was performed in The First Affiliate of General Hospital of PLA from January 2010 to January 2015, including 185 elderly intertrochanteric fractures. Patients were divided into complication group and non-complication group according to the existence of complications. The blood loss, pain, conscious disturbance, postoperative efficacy and incidence of complications were recorded and comparion were done between two groups. Results All patients were well followed up for 10-46 months with an average of 28±5 months. After PFNA treatment, The perioperative blood loss was 938±76 ml in non-complication group, which was significant lower than the complication group (1,125±107 ml), difference was statistically significant (t=18.436, P<0.05). The Harris Hip score in the non- complication group was 74.2 ± 2.9 points (36- 92), excellent rate was 91.9% , comparing to 85.6±2.3 points (48-93) and 75.0% excellent rate in the complication group, difference was statistically significant (U=3.124, P<0.05). In addition, 29/148 patients (19.6% ) in complication group gained postoperative complications, which was significantly higher than that of non- complication group (2/37, 5.4% ), difference was statistically significant (c2=4.580, P<0.05). The postoperative Glasgow scale of complication group[(9.2 ± 2.5)scores]was significantly higher than the non- complication group[(11.3 ± 3.4) scores] (t=18.635, P<0.05). The postoperative VAS score in complication group has no significant difference with the non- complication group. Conclusion The preoperative complications can greatly affect the efficacy of PFNA fixation in the treatment of intertrochanteric fractures in elderly.

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备注/Memo

备注/Memo:
基金项目：首都临床特色应用研究与成果推广（Z151100004015012）
更新日期/Last Update: 2017-04-01