老年髋部骨折患者不同手术时机治疗的近远期效果和预后比较
Comparison of Short-Term and Long-Term Efficacy and Prognosis of Different Surgical Timing Treatments for Elderly Patients with Hip Fractures
尚林强1
作者信息
- 1. 山东省单县海吉亚医院创伤骨科,山东 菏泽 274300
- 折叠
摘要
目的:比较老年髋部骨折患者不同手术时机治疗的近远期效果和预后,为临床手术时机的选择提供理论依据.方法:采用回顾性分析,收集我院骨科2019年1月—2020年12月收治的137例老年髋部骨折患者的资料,根据手术时机分为3组,伤后<48 h行手术治疗的 42 例患者为早期组,伤后 48～72 h行手术治疗的 51 例患者为中期组,伤后>72 h行手术治疗的 44例患者为晚期组,比较各组基本情况及手术相关指标.患者出院后均定期随访,采用Harris髋关节功能评分分别评价术前、术后1、3、6、12个月的髋关节功能,记录3组患者术后1、3、6、12 个月的死亡率及术后 12 个月内并发症发生率.结果:3 组患者平均住院时间比较,差异有统计学意义(P<0.05);组间两两比较,晚期组住院时间长于中期组,中期组长于早期组,组间差异有统计学意义(P<0.05).3 组术后各时间点Harris评分均明显高于术前,差异有统计学意义(P<0.05);3 组术前、术后 6、12 个月Harris评分比较,组间差异无统计学意义(P<0.05);早期组、中期组术后 1 个月Harris评分均高于晚期组,差异有统计学意义(P<0.05).3 组肺部感染率比较,差异有统计学意义(P<0.05);组间两两比较,早期组肺部感染率为 4.17%,低于晚期组的 16.28%,差异有统计学意义(P<0.05).3 组术后 1、3、6、12 个月的死亡率比较,组间差异无统计学意义(P>0.05).结论:老年髋部骨折患者的手术时机对死亡率无明显影响,但患者伤后尽早手术可缩短住院时间,降低肺部感染率,促进髋关节功能的快速恢复.
Abstract
Objective:To compare the short-term and long-term efficacy and prognosis of elderly patients with hip fracture treated at different times of operation,and to provide a theoretical basis for the selection of clinical operation times.Methods:Retrospective analysis was conducted to collect data on 137 elderly patients with hip fractures admitted to the orthopedics department of our hospital from January 2019 to December 2020,divided into 3 groups based on the timing of the surgery,42 patients who underwent surgical treatment within 48 hours after injury were included in the early group,51 patients who received surgical treatment at 48～72 h after injury were in the intermediate group,and 44 patients who received surgery>72 h after injury were in the late group.The basic conditions and surgical-related indicators were compared of each group.All patients were followed up regularly after discharge.Harris Hip Joint Function score was used to evaluate hip joint function at preoperative,postoperative 1,postoperative 3,postoperative 6,and 12 months,respectively.The mortality rates within 1,3,6,and 12 months after surgery and incidence of complications within 12 months after surgery for three groups of patients were recordcd.Results:There were significant differences in the average length of hospital stay among the three groups(P<0.05).Pairwise comparison between the two groups showed that the hospitalization time in the late group was longer than that in the intermediate group,and the hospitalization time in the intermediate group was longer than that in the early group,and the differences were statistically significant(P<0.05).The Harris scores at each time point after operation in the three groups were significantly higher than those before operation,and the differences were statistically significant(P<0.05).There were no significant differences in Harris score between the three groups before operation,6 months after operation,and 12 months after operation(P<0.05).The Harris scores of the early group and the middle group were higher than those of the late group at 1 month after operation,and the difference was statistically significant(P<0.05).There was a statistically significant difference in the lung infection rate among the three groups(P<0.05).Pairwise comparison between groups showed that the lung infection rate in the early group was 4.17%,which was lower than 16.28% in the late group,and the difference was statistically significant(P<0.05).There was no significant difference in mortality between the three groups at 1,3,6 and 12 months after operation(P>0.05).Conclusion:The timing of operation in elderly patients with hip fracture has no significant effect on mortality,but early operation after injury can shorten the hospital stay,reduce the rate of pulmonary infection,and promote the rapid recovery of hip function.
关键词
髋部骨折/老年人/手术时机/疗效/预后Key words
Operative timing/Elderly/Hip fracture/Efficacy/Prognosis引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据