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1、中華實(shí)用診斷與治療雜志2014年9月第28卷第9期JChinPractDiagnTher，September2014，Vo1．28，No．9·895··論著·人工肱骨頭置換術(shù)治療老年肱骨近端骨折臨床分析張明生，張仲寧，陳清漢，朱宇(鄭州大學(xué)第二附屬醫(yī)院骨科，鄭州45OO14)摘要：目的評(píng)價(jià)人工肱骨頭置換術(shù)治療老年肱骨近端骨折的效果。方法肱骨近端粉碎性骨折老年患者72例，根據(jù)手術(shù)方法分為觀察組36例和對(duì)照組36例，觀察組行肱骨頭置換術(shù)，對(duì)照組行鎖定鋼板內(nèi)固定術(shù)，比較2組手術(shù)時(shí)間、術(shù)中出血量、術(shù)后引流量、住院時(shí)間和并發(fā)癥發(fā)生情況，采用Constant—Murley評(píng)分系統(tǒng)對(duì)肩關(guān)節(jié)功能恢復(fù)
2、情況進(jìn)行評(píng)價(jià)。結(jié)果觀察組手術(shù)時(shí)間((85．7±9．4)min)、術(shù)中出血量((187．6士29．7)mL)、術(shù)后引流量((60．5±6．4)mL)和住院時(shí)間((10．3士2．1)d)與對(duì)照組((103．14-1I．2)rain、(250．3±34．2)mL、(78．1±5．9)mL、(14．5-2_-1．9)d)比較差異有統(tǒng)計(jì)學(xué)意義(P<0．05)；術(shù)后3個(gè)月及1a觀察組Constant—Murley評(píng)分((61．3±4．7)、(67．4±3．4)分)高于對(duì)照組((52．7±3．8)、(60．8士2．9)分)(P<0．05)；觀察組并發(fā)癥發(fā)生率(11．1％)與對(duì)照組(16．7)比較差
3、異無(wú)統(tǒng)計(jì)學(xué)意義(P>0．05)。結(jié)論肱骨頭置換術(shù)治療老年肱骨頭近端粉碎性骨折療效確切，與鎖定鋼板內(nèi)固定術(shù)相比，具有手術(shù)時(shí)間短、術(shù)中出血量少、住院時(shí)間短及并發(fā)癥發(fā)生率低等優(yōu)點(diǎn)。關(guān)鍵詞：肱骨近端骨折；人工肱骨頭置換術(shù)；鎖定鋼板內(nèi)固定術(shù)；老年人；效果EffectofartificialhumeralheadreplacementonproximalhumerusfracturesinelderlypatientsZHANGMing—sheng，ZHANGZhong—ning，CHENQing—han．ZHUYu(DepartmentofOrthopedics，theSecondHospit
4、alAffiliatedtoZhengzhouUniversity，Zhengzhou450014，China)Abstract：0bjectiveToevaluatetheeffectofartificialhumeralheadreplacementonproximalhumerusfracturesinelderlypatients．MethodsSeventy-twoelderlypatientswithproximalhumerusfracturesweredividedintoobservationgroupandcontrolgroupbasedontheoperati
5、onmethods，with36patientsineachgroup．Observationgroupreceivedartificialhumeralheadreplacementandcontrolgroupreceivedlockingplate．Theoperationduration，bloodlossvolume，postoperativedrainagevolume，hospitalizationstayandcomplicationswererecordedintwogroups．Theshoulderfunctionrecoverywasevaluatedbyus
6、ingConstant—Murleyscoringsystem．ResultsTheoperationduration，bloodlossvolume，postoperativedrainagevolumeandhospitalizationstaywere(85．7土9．4)min，(187．6_-4-29．7)mL，(60．54-6．4)mLand(10．3士2．1)daysinobservationgroup，significantlydifferentfromthoseincontrolgroup((103．14-11．2)min，(25O．3±34．2)mL，(78．I±5
7、．9)mL，(14．5士1．9)days)(P<0．05)．Constant—Murleyscoresin3monthsandoneyearafteroperationwere61．3±4．7and67．4-4-3．4inobservationgroup，higherthanthoseincontrolgroup(52．7±3．8，6O．8±2．9)(P<0．05)．Therewasnosignificantdifferenceintheincidence
