临床外科杂志 ›› 2019, Vol. 27 ›› Issue (2): 160-162.doi: 10.3969/j.issn.10056483.2019.02.024

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双极人工股骨头治疗股骨颈骨折合并帕金森病的疗效

  

  • 出版日期:2019-02-20 发布日期:2019-02-20

The outcome of bipolar femoral head replacement in femoral neck fracture patients with Parkinson’s disease

  • Online:2019-02-20 Published:2019-02-20

摘要: 目的:总结双极人工股骨头治疗Garden Ⅲ型或Ⅳ型股骨颈骨折合并帕金森病(PD)的临床疗效。方法:股骨颈骨折合并PD 23例,采用人工双极股骨头置换术治疗移位明显的股骨颈骨折,并评估其疗效。结果:所有病人术中术中出血量为120~360ml,平均出血量(220.0±34.5)ml,手术时间为50~75分钟,平均手术时间(65.0±10.5)分钟。有4例随访丢失,有2例因心脑血管事件分别于术后3个月和9个月死亡,1例因肺部感染于术后14个月死亡。术后出现常见并发症为肺部感染、小腿肌间静脉血栓和泌尿系感染。术后1年的Harris评分优4例,良12例,可4例,差1例,2例分别于术后3个月和9个月死亡未评分,优良率69.6%。结论:对于合并PD的Garden Ⅲ型或Ⅳ型股骨颈骨折病人,手术风险大,术后并发症发生率较高,术后康复难以配合,周期较长。人工双极股骨头置换是一种较好的选择。

关键词: 股骨颈骨折, 帕金森病, 双极人工股骨头

Abstract: Objective:To evaluate the clinical efficacy of bipolar femoral head replacement for Garden stage Ⅲ and Ⅳ femoral neck fracture patients accompanied with Parkinson’s disease.Methods:23 bipolar femoral head replacement were performed in femoral neck fracture patients with Parkinson's disease.Artificial bipolar femoral head replacement for displaced femoral neck fractures was performed and its efficacy was evaluated.Results:The average blooding loss was(220.0±34.5)ml(120~360ml).The average operating time was(65.0±10.5)min(50~75min).Followup was lost in 4 patients,2 patients died of cardiovascular and cerebrovascular events at 3 and 9 months after surgery,and 1 patient died of pulmonary infection at 14 months after surgery.Common postoperative complications were pneumonia,deep vein thrombosis and urinary tract infection.The Harris hip score was excellent in four patients,good in twelve patients,fair in four patients and poor in one patients after one year operation.Two patients died at 3 and 9 months postoperatively without scoring,excellence rate was 69.6%.Conclusion:Bipolar femoral head replacement is a satisfactory treatment for the femoral neck fractures in patients accompanied with Parkinson's disease,but the incidence of complications is high and the function recovery is difficult.

Key words: femoral neck fracture, Parkinson’s disease, bipolar femoral head replacement

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