老年人母趾外翻畸形围手术期处理

老年人母趾外翻畸形围手术期处理 老年人母趾外翻畸形围手术期处理 【摘要】 探讨老年人母趾外翻畸形围手术期处理的意义和诊治 要点。,,自2000年1月,2006年12月实施老年人母趾外翻矫 形术45例，69足;病人年龄60,79岁，平均66.6岁，伴随疾病9 种，共46个病变。手术前对伴随疾病作全面诊断，妥善治疗。根据 母趾外翻畸形程度、病人年龄及伴随症选择最佳麻醉和手术方式。术 后注意预防各种并发症及实施适合老年人的康复治疗。,结果,本组 45例，手术全部成功。围手术期伴随疾病无发作或加重，未出现全 身及局部并发症。术后患足X线片，与术前比较:母趾外翻角平均改 善25?;第?、?跖骨间角平均改善7?。,结论,老年人母趾外翻 畸形保守治疗无效应当采取手术治疗，完善的围手术处理是手术成功 和病人安全的保证。 【关键词】 母趾外翻 畸形 老年病人 围手术期 Abstract:,Objective,To explore the significance and methods of the diagnosis and treatment in the geriatric patients ith hallux valgus deformity during the perioperative period.,Method,Forty five corrective operations(69 feet)ere performed on hallux valgus deformity in geriatric patients beteen January 2000 and December 2006.The mean age of the patients ere 66.6 years(ranging 60~79 years).These 45 patients had other varying number of acpanying diseases,9 different kinds in all hich also added up to 46 in total number.Prior to the operations,prehensive diagnosis ere made of the acpanying diseases hich ere also properly treated.The best anaesthesia and operative methods ere chosen according to the extent of the deformities,age of the patients and their acpanying diseases.After the operation,attention should be paid to prevent various plications and appropriate post operation rehabilitation treatments should be adopted for these geriatric patients.,Result,All of the 45 cases ere successful ith no onset or aggravation of the acpanying diseases during the perioperative period,nor did general or local plications appeared.Comparisons made beteen post and pre operation X ray plates of the troubled feet indicated that a mean 25 degree improvement ere achieved for HVA and a mean 7 degree improvement for IMA.,Conclusion,When conservative treatments of the hallux valgus deformity in the geriatric patient being proved ineffective,operative treatment should be suggested.Proper and meticulous perioperative management is the guarantee for the success of the operation and the safety of the patient. Key ords:hallux valgus; deformity; geriatric patient; perioperation period 随着老年人口的增加以及人们对高质量生活的追求，老年人母趾外 翻畸形手术矫形病例不断增多。老年患者生理功能减退，许多人合并 慢性疾病，耐受麻醉和手术的能力较差，围手术期治疗不当可能出现 各种并发症。因此，围手术期应当给与特殊关注和妥善处理。现在将 作者的治疗经验报道如下。 1 资料与方法 1.1 一般资料 2000年1月~2006年12月本院实施老年人 母趾外翻矫形手术45 例(69足)，男6例，女39例;年龄60~79岁，平均66.6岁。病变 部位:左足9例，右足12例，双足24例，共计69足。病程2~50年， 平均17年。全部病例均有 母趾畸形、疼痛和(或)功能障碍。平 均 母趾外翻角37?，第?、?跖骨间角12.9?;63.6,的病例有 跖 母关节退行性改变。