[1]赵辉 王勇平.不同体位及牵引力对股骨颈骨折后髋关节囊内压的影响[J].中国中医骨伤科杂志,2021,29(02):45-48.
 ZHAO Hui WANG Yongping.Effects of Different Postures and Traction on the Pressureof Hip Joint Capsule after Femoral Neck Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(02):45-48.
点击复制

不同体位及牵引力对股骨颈骨折后髋关节囊内压的影响()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年02期
页码:
45-48
栏目:
临床报道
出版日期:
2021-02-15

文章信息/Info

Title:
Effects of Different Postures and Traction on the Pressureof Hip Joint Capsule after Femoral Neck Fracture
文章编号:
1005-0205(2021)02-0045-04
作者:
赵辉1 王勇平1
1兰州大学第一医院骨科(兰州,730099)
Author(s):
ZHAO Hui1 WANG Yongping1
1Department of Orthopedics,the First Hospital of Lanzhou University,Lanzhou 730099,China.
关键词:
股骨颈骨折 髋关节囊内压 牵引力 不同体位
Keywords:
femoral neck fracture hip capsule pressure traction different body positions
分类号:
R683.42
文献标志码:
B
摘要:
目的:分析不同体位及牵引力对股骨颈骨折后髋关节囊内压的影响。方法:选择2017年4月至2019年5月收治的160例股骨颈骨折患者为研究对象,通过测量患者髋关节囊内压,对比不同股骨颈骨折类型下,患者在不同牵引力及不同体位时所测得的髋关节囊内压。结果:160例患者中,最终124例(Garden Ⅰ型30例,Garden Ⅱ型50例,Garden Ⅲ型36例,Garden Ⅳ型8例)患者纳入结果分析; 未纳入结果分析的36例患者中,30例患者在任何体位下髋关节囊内压无明显变化,6例患者在置入探头过程中出现压力骤增。124例患者中,不同体位下髋关节囊内压存在明显差异; 外旋30°状态下髋关节囊内压明显低于其他体位,差异有统计学意义(P<0.05); 内旋60°状态下囊内压明显高于其他体位,差异有统计学意义(P<0.05)。在不同体位下髋关节囊内压随骨折分型的递增而升高,差异有统计学意义(F=34.500,55.110,73.740,36.830,54.500,62.310,P<0.05)。髋关节囊内压随牵引力的增加而上升,差异有统计学意义(P<0.05); 髋关节囊内压随骨折分型的递增而上升(F=39.400,51.020,46.360,14.450,P<0.05)。结论:髋关节囊内压升高是股骨颈骨折后常见的临床表现,体位与牵引力是影响囊内压的主要因素,当髋关节处于外旋状态下时囊内压最低,内旋状态下最高。囊内压随牵引力的增加而上升。
Abstract:
To analyze the influence of different postures and traction on the internal pressure of hip joint capsule after femoral neck fracture.Methods:160 patients with femoral neck fractures were selected as the research objects from April 2017 to May 2019.By measuring the internal pressure of the hip joint capsule of the patients,the patients under different types of femoral neck fractures under different traction and different positions measured internal pressure of hip joint capsule.Results:160 patients in this group,the final 124(30 Garden Ⅰ,50 Garden Ⅱ, 36 Garden Ⅲ, and 8 Garden Ⅳ)patients were included in the analysis of results.36 patients who were not included in the analysis of results,30 patients showed no significant changes in hip capsule pressure in any position,and 6 patients experienced a sudden increase in pressure during the probe placement.A comparative analysis of 124 patients included in the study results found that there were significant differences in the internal pressure of the hip joint capsule under different positions.The internal pressure of the hip joint capsule was significantly lower than other positions under external rotation of 30°(P<0.05),and the internal pressure of the capsule was significantly higher than other positions under internal rotation of 60°(P<0.05).In different positions,the hip capsule pressure increased with increasing fracture classification(F=34.500,55.110,73.740,36.830,54.500,62.310,P<0.05).Hip capsule pressure increased with increasing traction(P<0.05).Hip capsule pressure increased with increasing fracture classification(F=39.400,51.020,46.360,14.450,P<0.05).Conclusion:Increased internal pressure of the hip joint capsule is a common clinical manifestation after femoral neck fracture.Position and traction are the main factors that affect the internal pressure of the capsule.When the hip joint is in external rotation,the internal pressure is the lowest,and when the hip is in internal rotation highest.The pressure inside the sac increases as the traction increases.

参考文献/References:

[1] 韩宜印,孙夫超,凡祥军,等.续骨活血汤对股骨颈骨折患者空心螺钉内固定术后疗效及生活质量的影响[J].国际中医中药杂志,2017,39(3):204-207.
[2] 瞿群威,陈四海,王胜成,等.针刀对股骨头缺血性坏死患者髋关节囊内压和骨内压影响的临床研究[J].针灸临床杂志,2013,30(7):46-49.
[3] 李贵春,王文己.不同方式修复老年新鲜股骨颈骨折的对比[J].中国组织工程研究,2015,19(9):1393-1399.
[4] SHI Y,CHEN Z J,HONG Z Y,et al.Case-control study on retaining articular capsule in the total hip replacement for old patients with unstable femoral neck fractures[J].China Journal of Orthopaedics and Traumatology,2016,29(11):989-993.
[5] 姚伟,李能平.微创前外侧入路下不同髋关节置换方式对股骨颈骨折患者骨代谢、关节疼痛的影响[J].海南医学院学报,2017,23(20):2791-2793.
[6] 邓波,王静成,熊传芝,等.老年股骨颈骨折Garden分型对围手术期隐性失血的影响[J].江苏医药,2016,41(10):1173-1174.
[7] 余希临,桂彤,沈先涛.发育性髋关节脱位复位前后关节腔动态测压的临床意义[J].中华小儿外科杂志,2005,25(3):29-31.
[8] 鲁保华.全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的效果[J].中国医药导报,2015,35(3):37-40.
[9] 刘利君,彭明惺,孔古娅,等.小儿髋关节两种不同方法的压力测定及其与不同体位变化规律的探讨[J].中华骨科杂志,1997,17(12):748-750.
[10] 华祖广,庞清江,郑兴国.股骨颈骨折后髋关节囊压力改变的临床研究[J].现代实用医学,2008,20(1):11-12.
[11] 黄屾.髋关节置换术与骨折内固定术治疗新鲜移位的老年股骨颈骨折的疗效对比[J].创伤外科杂志,2016,18(4):223-225.
[12] 刘大海,李海波,苟永胜,等.不同体位及牵引质量对股骨颈骨折后髋关节囊内压的影响[J].中国组织工程研究,2019,23(36):5846-5849.
[13] PAUSER J,NORDMEYER M,BIBER R,et al. Incisional negative pressure wound therapy after hemiarthroplasty for femoral neck fractures-reduction of wound complications[J].International Wound Journal,2014,13(5):525-526.
[14] 李志,张英泽,彭阿钦,等.股骨颈骨折后的髋关节内压[J].上海医学,2006,28(6):71-72.
[15] 伍凯,张明贵,曹云,等.股骨颈骨折后关节囊压力对股骨头血供的影响[J].中国矫形外科杂志,2002,12(10):984-986.

备注/Memo

备注/Memo:
基金项目:甘肃省卫生行业科研计划项目(GSWSKY-2015-53)
更新日期/Last Update: 2021-02-15