标题：长柄髋关节置换治疗高龄股骨粗隆间骨折36例

      作者：黄桂雄，罗世兴，纪德朋，钟毅，黄敬叶    广西医科大学第九附属医院关节脊柱骨科，广西 北海 536000

      卷次： 2019年30卷10期

      【摘要】 目的 探讨长柄髋关节置换治疗高龄股骨粗隆间骨折的疗效。方法 回顾性分析 2005年 1月至2017年12月广西医科大学第九附属医院关节脊柱骨科收治的36例采用长柄髋关节置换治疗高龄股骨粗隆间骨折患者的临床资料。结果 所有患者手术过程均顺利，手术时间45~120 min，平均(86.7±20.4) min；长柄35例半髋，全髋1例；术中平均出血300 mL，术后第1天平均引流266 mL，平均输血量694 mL，术后血红蛋白71~126 g/L，平均(98.1±12.9) g/L；2例术前并发肺炎，4例术后出现肺炎，2例术后出现呼衰围手术期死亡，3例心衰出院后3个月内死亡；均无伤口并发症。24例获1年以上随访，患者功能良好，生活自理，室内外行程基本不限，无需扶拐杖，上下楼梯自如，未出现人工关节脱位，松动，无大腿疼痛。结论 长柄髋关节置换治疗高龄股骨粗隆间骨折是安全可行的。
      【关键词】 长柄假体；髋关节置换；股骨粗隆间骨折；高龄；疗效
      【中图分类号】 R683.42 【文献标识码】 A 【文章编号】 1003—6350（2019）10—1313—03

Effect of hip replacement with long-stem prosthesis in the treatment of intertrochanteric fracture of elderlypatients: a report of 36 cases.
HUANG Gui-xiong, LUO Shi-xing, JI De-peng, ZHONG Yi, HUANG Jing-ye. Departmentof Orthopedics, the Ninth Affiliated Hospital of Guangxi Medical University, Beihai 536000, Guangxi, CHINA
【Abstract】 Objective To study the effect of hip replacement with long-stem prosthesis in the treatment of inter-trochanteric fracture of elderly patients. Methods The clinical data of 36 patients with intertrochanteric fractures treat-ed by hip arthroplasty with long-stem prosthesis in the Department of Orthopaedics, the Ninth Affiliated Hospital ofGuangxi Medical University from January 2005 to December 2017 were retrospectively analyzed. Results The opera-tion time was 45-120 minutes, with an average of (86.7±20.4) minutes. Among the 36 cases, there were 35 cases ofhemiarthroplasty and only one case of total hip arthroplasty. The average intraoperative blood loss was 300 mL. The av-erage drainage time was 266 mL on the first day after operation, and the average blood transfusion volume was 694 mL.The postoperative hemoglobin level was 71 g/L to 126 g/L, with an average of (98.1±12.9) g/L. In this study, 2 patientshad pneumonia before operation, 4 patients developed pneumonia after operation and 2 patients died of respiratory fail-ure after surgery, 3 patients died of heart failure within 3 months after discharge. There were no wound complications.Twenty-four patients were followed up for more than 1 year, and the patients had good recovery, with basically unlimitedindoor and outdoor travel, no need for crutches, no difficulty in going up and down stairs, no artificial joint dislocationand loosening, and no thigh pain. Conclusion Hip replacement with long-stem prosthesis is safe and feasible for thetreatment of intertrochanteric fractures in the elderly.
      【Key words】 Long stem prosthesis; Hip replacement; Femoral intertrochanteric fracture; The elderly; Effect·短篇论著·doi:10.3969/j.issn.1003-6350.2019.10.026基金项目：广西北海市科学技术局项目(编号：201602027)