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目的: 观察采用国产Gamma 钉固定手术用于老年股骨转子间骨折的疗效, 探讨治疗老年股骨转子间骨折更为有效的方法及围手术期并发症的防治措施。方法: 将60 例老年股骨转子间骨折患者, 按入院的先后顺序随机分为观察组和对照组各30 例。观察组采用国产Gamma 钉固定治疗, 对照组采用L 形加压钢板固定治疗。对两种手术的平均切口长度、手术时间和输血量、骨折愈合时间及整体疗效进行对比, 并作统计分析, 计量资料采用t 检验, 计数资料采用X2 检验。结果: 两组切口长度、手术时间和输血量相比, 具有显著性差异和非常显著性差异( P< 0. 05, P< 0. 01) 。骨折愈合时间和整体疗效相比, 也具有显著性差异 ( P< 0. 01) , 观察组手术疗效优于对照组。结论: Gamma 钉用于老年股骨转子间骨折治疗, 由于手术呈非开放式或半开放式, 具有操作简单、固定可靠、手术创伤小、失血少、不直接影响骨折端血液供应, 具有闭合整复固定的优点, 有利于骨折的愈合, 是治疗老年股骨转子间骨折较为适宜的手术方法。

英文摘要:

Objective: To evaluate the curative effect of the Gamma nail( made in China) fixation( GNF) in the treatment of senile intertrochanteric fractures of femur( SIFF) , and to discuss more effective therapy and measures of prevention and treatment. Methods: 60 patients with SIFF, in the hospitalized order, were randomly divided into observation group( n= 30) and control group( n= 30) . The observation group was treated with GNF; the control group with L- form forcing steel plate fixation. Mean incisal opening( IO) length, time of surgery( TS) , quantity of blood transfusion( QBT) , union time of fracture( UTF) and total curative effect( TCE) of the two operations were compared and statist-i cally analysed. Measurement data were analysed with t test, and numeration data with x2 test. Results: There were significant differences in IO length, TS and QBT between the two groups( P< 0. 05, P< 0. 01) . There was also marked difference between UTF and TCE( P< 0. 05) , and the observation group was superior to the control group. Conclusion: Because GNF of SIFF is closed or half- open operation, and in favour of union of fracture, it has many advantages such as simple operation, better stability, small trauma and less blood loss etc. , which is more eligible for the treatment of SIFF.

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