髋关节置换术与内固定术治疗老年股骨颈骨折的临床效果比较

Clinical effects comparison of treatment of hip replacement and internal lixation for aged patients with fracture of femoral neck

目的比较髋关节置换术与内固定术治疗老年股骨颈骨折的临床效果。方法选取112例诊断为股骨颈骨折的老年患者为研究对象，根据患者及家属意愿采取不同的治疗方法分为观察组和对照组，每组56例。对照组采用切开内固定术治疗，观察组给予髋关节置换术治疗。术后随访6个月，比较两组患者手术时间、术中出血量、住院时间、卧床时间、术后并发症及Harris关节评分。结果观察组与对照组比较，手术时间[（98．6±23．8）、（54．2±16．4）min，t=4．468，P〈0．05]；术中出血量[（324．6±43．8）、（158．6±26．8）ml，t=5．624；P〈0．05]高于对照组，差异有统计学意义；卧床时间[（16．6±2．8）、（68．6±5．8）d，t=8．248，P〈0．05]明显少于对照组。观察组压疮、肺部感染及再次手术例数明显少于对照组，差异有统计学意义（P均〈0．05）；观察组Harris关节评分优良率89．7％（50／56）明显高于对照组58．9％（33／56），差异有统计学意义（χ^2=14．423，P〈0．05）。结论髋关节置换术治疗老年股骨颈骨折患者可明显改善术后患肢功能，改善生活质量。

Objective To compare the clinical effects of hip replacement and internal lixation treatment for aged patients with fracture of femoral neck. Methods One hundred and twelve cases patients with fracture of femoral neck were choosed and divided into the control group （n = 56） and observation group （n = 56） according to the will of patients and family. The control group was treated by incision fixation while the observation group was given hip replacement therapy. All patients were followed up for 6 months after the operation time. Intraoperative blood loss, hospital stay, bed time, postoperative complications and Harris joint scores of the two groups were compared. Results The operation time and intraoperative blood loss of the observation group were significantly higher than those of the control group （98.6 ± 23.8 ） min vs. （ 54. 2 ± 16. 4 ） rain, （ 324. 6 ±43.8） ml vs. （ 158.6±26. 8） ml;t=4. 468,5. 624;P〈0. 05） ;The bed time was much shorter than that of the control group（ （ 16. 6±2. 8） d vs. （68.6±5.8） d;t = 8. 248,P〈0. 05）. The case of pressure sores,lung infection and mode again of the observation group were significantly less than those of the control group（ P〈0.05 ） ,while the Harris joint scores were significantly higher than the control group （ 89. 7% vs 58. 9%, X2 = 14. 423, P 〈0. 05）. Conclusion Hip replacement can improve the joint function and enhance the quality of life for patients of fracture of femoral neck.