Objective To summarize the latest research progress of bone cement type femoral head replacement in the treatment of unstable intertrochanteric fractures in elderly patients. Methods The literature on the application of bone cement type femoral head replacement for unstable intertrochanteric fractures in elderly patients both domestically and internationally was reviewed, and the findings in aspects of selection of prosthesis types, proximal femoral reconstruction methods, postoperative complications, and rehabilitation were summarized and analyzed. Results The bone cement type femoral head replacement has shown significant effectiveness in the treatment of unstable intertrochanteric fractures in elderly patients. The surgery provides immediate stability, allowing patients to quickly bear weight and regain walking function, thereby reducing the incidences of postoperative complications and mortality. However, due to the generally poor physical condition and low surgical tolerance of elderly patients, the risk of postoperative complications significantly increases, which has a significant impact on patients’ postoperative recovery. Common complications include deep vein thrombosis, bone cement implantation syndrome, joint dislocation, prosthesis loosening, and periprosthetic fractures. Therefore, despite the apparent short-term effectiveness of the surgery, it is crucial to emphasize the prevention and management of postoperative complications to improve the long-term prognosis of elderly patients. Conclusion For unstable intertrochanteric fractures in elderly patients, when choosing bone cement type femoral head replacement, it is necessary to strictly adhere to surgical indications, reduce the occurrence of complications, and improve the patients’ quality of life through refined preoperative evaluation, intraoperative operation, and effective postoperative management.
目的 探讨预防左半结肠癌伴梗阻Ⅰ期切除吻合术后吻合口漏发生的新方法。方法 将215例左半结肠癌伴梗阻接受术中结肠灌洗和Ⅰ期切除吻合等处理的患者分为两组。双管引流组术中经肛门放置肠腔内双管引流;扩肛组术中不放置肠腔内引流管,术后定时扩肛。对两组患者术后腹腔脓肿和吻合口漏发生率进行对比分析。结果 腹腔脓肿和吻合口漏发生率双管引流组分别为3.1%(4/130)和3.8%(5/130),扩肛组分别为10.6%(9/85)和12.9%(11/85),两组腹腔脓肿和吻合口漏发生率之差异均有显著性意义(P<0.05)。结论 肠腔内双管引流法具有预防性结肠“内造瘘”、减压减张、冲洗洁净和持续性扩肛作用,能有效地预防和减少左半结肠癌伴梗阻I期切除吻合术后吻合口漏的发生。
目的 为减少直肠癌保肛术后并发症。 方法对421例直肠癌患者保肛术中行吻合口上下双管引流术。 结果双管引流组术后吻合口漏发生率为0.71%(3/421),无1例发生吻合口狭窄;对照组术后吻合口漏发生率为11.20%(14/125),吻合口狭窄发生率为6.40%(8/125),与双管引流组相比差异有显著性意义(P<0.01)。结论吻合口上下双管引流法能有效地减少直肠癌保肛术后并发症的发生。