摘要
目的探讨不同手术时机对老年股骨转子间骨折康复效果的影响。方法选取该院2013-01~2015-05收治的老年股骨转子间骨折患者40例为研究对象,以随机数字表法分为早期组与延期组,每组20例,早期组1周内进行手术,延期组1周后手术,比较两组术后并发症发生率;随访12个月比较两组生活质量、髋关节功能变化及病死率。结果早期组并发症发生率为15.0%,与延期组（45.0%）比较差异有统计学意义（P〈0.05）。两组术前日常生活能力评分（ADL）及髋关节功能评分比较差异无统计学意义（P〉0.05）,术后6个月早期组ADL及髋关节功能评分分别为（55.16±11.19）分、（77.16±7.58）分,与延期组[（42.77±12.99）分、（65.11±6.97）分]比较差异有统计学意义（P〈0.05）,12个月时两组评分比较差异无统计学意义（P〉0.05）。随访1年,早期组病死3例,病死率为15.0%;延期组病死4例,病死率为20.0%,两组病死率比较差异无统计学意义（χ^2=0.173,P〉0.05）。结论早期手术可降低老年股骨转子间骨折患者并发症发生率,尤其在预防长期卧床导致的感染性并发症及压疮方面效果显著,且可改善患者术后6个月生活质量及髋关节功能,而不同手术时机对病死率的影响仍有待大样本量的深入研究。
Objective To explore the rehabilitative effect of operative timing on intertrochanteric fractures in elderly patients. Methods Forty elderly patients with intertrochanteric fractures in our hospital were collected as the research subjects from January 2013 to May 2015. They were randomly divided into two groups in which the early surgery group（ n = 20） had an operation within one week and the later surgery group（ n = 20） had an operation more than one week. The outcomes including the incidence of post-operative complications,the quality of life,the hip joint function and the fatality rate were compared between the two groups after a follow-up of one year. Results The incidence of post-operative complications in the early surgery group（ 15. 0%） was significantly lower than that in the latter surgery group（ 45. 0%）（ P〈0. 05）. No significant differences were found between the two groups in ADL scores and hip joint function before the operation（ P〉0. 05）. ADL scores were（ 55. 16 ± 11. 19） and（ 42. 77 ± 12. 99）,and the hip joint function scores were（ 77. 16 ± 7. 58） and（ 65. 11 ± 6. 97） in the early surgery group and the later group 6 months after the surgery respectively,with a significant difference between the two groups（ P〈0. 05）. There were no significant differences in ADL scores and the hip joint function scores 12 months after the surgery（ P〉0. 05）. Three cases died in the the early surgery group（ 15%）,and 4 cases died in the later surgery group（ 20%）one year after the operation（ χ^2= 0. 173,P〉0. 05）. Conclusion Early surgery is associated with the decreased post-operative complications,especially for preventing infectious complications and pressure ulcer in long-term bedridden patients,and therefore improves the quality of life and the hip joint function 6 months after the surgery. Population-based studies are needed to confirm the impact of timing of surgery on the fatality rate.
出处
《中国临床新医学》
2016年第8期672-675,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
安徽省科技计划项目(编号:1401045022)
关键词
股骨转子间骨折
早期手术
康复
生活质量
Intertrochanteric fractures
Early surgery
Rehabilitation
Quality of life
