摘要
目的探讨六部分骨折分型在减少和预防股骨转子部骨折患者围手术期风险中的应用价值。方法选取2012年3月至2016年4月期间收治的318例股骨转子部骨折手术患者,按照随机数字表法将所有患者随机分为三组,对三组患者分别进行AO分型和改良Evans分型以及六部分骨折分型处理。对于改良Evans分型中的IA、IB型骨折患者以及AO分型中A1、A2.1型患者和六部分骨折分型中顺粗隆间骨折的两部分骨折患者均采用股骨近端防旋髓内钉(PFNA)、动力髋螺钉(DHS)以及Gamma钉进行手术;而对于改良Evans分型以及AO分型、六部分骨折分型中稳定型之外的患者则一律采用PFNA、Gamma钉、髋关节置换进行手术。分析比较三种不同分型患者的出血量、手术时间、术后并发症发生情况、负重时间、Harris评分、骨折愈合时间以及住院时间等指标。结果 DHS组的对比中,六部分骨折分型患者的手术时间和出血量以及骨折愈合时间等均低于改良Evans分型和AO分型的患者(P<0.05),而六部分骨折分型患者的Harris评分则明显高于另外两种分型患者(P<0.05),三组患者的负重时间和住院时间则无显著差异(P>0.05)。六部分骨折分型与另外两种分型在PFNA组和Gamma组中的手术时间、住院时间、骨折愈合时间、负重时间、Harris评分方面均无显著差异(P>0.05)。六部分骨折分型患者在内置物并发症以及心血管系统、活动性出血、泌尿系感染、肺炎、压疮、下肢深静脉血栓等方面的并发症发生率均显著低于另外两种分型患者(P<0.05)。结论六部分骨折分型能够比改良Evans分型和AO分型更加准确地反映患者股骨转子部骨折情况,在内固定方式的选择上具有更高的指导作用,同时也能较好地改善患者病情和治疗预后。
Objective To explore the application of six part fracture classification in reducing and preventing the risk of perioperative patients with femoral intertrochanteric fracture.Methods During March 2012 to April 2016 318 cases with femoral intertrochanteric fracture were selected in this study,according to random number table method,all of the patients were randomly divided into three groups.AO and improved Evans points and six part fracture classification were processed.For improving Evans type classification of IA and IB fracture patients and patients with AO type A1,A2.1 type and six part fracture classification along the intertrochanteric fracture in patients with fracture were performed PFNA,DHS and Gamma nail;For improved Evans points and AO,part six stable fracture classification of patients with PFNA,Gamma nail,hip replacement surgery.Blood loss,operative time,postoperative complications,load time,Harris scoring index,fracture healing time and hospital stay,etc in three types were compared.Results In the comparison the DHS group,the operation time and blood loss,fracture healing time in the six part type were lower than those in the modified Evans and AO classification of patients （P＆lt;0.05）,while Harris score was significantly higher than that of the other two types of patients （P＆lt;0.05）.Load time and hospitalization time has no significant difference （P＆gt;0.05）.The operation time,hospitalization time,fracture healing time,weight-bearing time,Harris scores in the three group had no significant differences （P＆gt;0.05）.The occurrence rate of complications of the implants and the cardiovascular system,active bleeding,urinary tract infection,pneumonia,bedsore,deep vein thrombosis and other aspects in the six part fracture typewere significantly lower than those of the other two types of patients （P＆lt;0.05）.Conclusion The six part fracture type can more accurately reflect the situation of patients with femoral intertrochanteric fracture than the modified Evans and AO classification,it has a guiding role in higher internal fixation choice,but also can effectively improve the prognosis.
出处
《临床和实验医学杂志》
2017年第13期1319-1322,共4页
Journal of Clinical and Experimental Medicine
关键词
股骨转子部骨折
骨折分型
创伤评分系统
围手术期
风险
Femoral intertrochanteric fracture
Fracture type
Trauma scoring system
Perioperative period
Venture
