摘要
背景:临床上髋部骨折常通过手术进行治疗,但是由于老年患者各脏器功能衰退而增加了术后继发合并症的危险。目的:综述近年国内外髋部骨折植入物及其并发症的研究进展。方法:第一作者应用计算机检索1994年1月至2015年10月Pub Med和CNKI中文期刊全文数据库有关髋部骨折植入物及其并发症的文章,英文检索词"hip fracture,implants,complications";中文检索词"髋部骨折,植入物,并发症"。共检索到128篇相关文献,52篇文献符合纳入标准。结果与结论:20%的髋部骨折患者会发生并发症,包括医学方面及手术治疗本身的。文章依据髋部骨折的临床分类不同,分两方面对髋部骨折植入物并发症进行了阐述。一方面以髋部骨折手术常用植入物为切入点阐述其常见的并发症;另一方面以髋部骨折部位为切入点阐述髋部骨折植入物并发症。髋部骨折植入物相关的常见并发症有髋内翻、关节脱位、植入物退出或切割股骨头等。早期内固定、抗血栓和预防感染、围手术期疼痛管理、精神错乱的及时发现和控制、正确的尿路管理、预防营养不良、补充维生素D、骨质疏松症的治疗和早期功能活动的改善,是髋部骨折患者的最佳保养建议。近年来随着内固定技术及术后处理的日益完善,以及早期康复的介入,更多的学者主张早期内固定治疗,目的是加快患者髋关节功能恢复以及防止再跌倒。
BACKGROUND：Hip fracture is often clinical y treated by surgical, but the elderly patients due to viscera function recession are faced with the risk of postoperative secondary complications. OBJECTIVE：To summarize the research progress of hip fracture implants and its complications at home and abroad in recent years. METHODS：The articles related with hip fracture implants and its complications were retrieved from PubMed database and CNKI Chinese periodical ful-text database from January 1994 to October 2015 by the first author using computer. The English and Chinese key words were“Hip Fracture, Implants, Complications”. Total y 128 relevant documents were retrieved, and 52 met the inclusion criteria. RESULTS AND CONCLUSION：Total y 20%of patients with hip fracture wil have complications. Some of these are medical, and other relate to the surgical treatment itself. Our review expounded the two aspects of hip fracture implant complications according to different clinical classification of hip fracture. On one hand, the common complications of hip fracture surgery were explained by taking the commonly used implants in hip fracture surgery as the breakthrough point;on the other hand, the implant complications of hip fracture were explained by taking the fracture site as the breakthrough point. Common complications related to hip fracture implants were hip varus, joint dislocation, implants exit or femoral head cutting. Early surgical internal fixation, anti-thromboembolic and anti-infective prophylaxis, perioperative pain management, timely detection and control of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and the improvement of early functional activities are basic recommendations for an optimal maintenance of hip fractured patients. In recent years, with the increasing improvements of internal fixation technology and post-operative management, as wel as early rehabilitation intervention, more scholars advocate in an early internal fixation treatment, so as to accelerate the functional recovery of patients’ hip joint and prevent further fal s.
出处
《中国组织工程研究》
CAS
北大核心
2015年第48期7811-7818,共8页
Chinese Journal of Tissue Engineering Research
