老年股骨颈骨折患者行人工全髋关节置换与半髋置换术对关节功能恢复的影响

Effect of Total Hip Replacement and Hemihip Replacement on Joint Function Recovery in Elderly Patients with Femoral Neck Fracture

目的探讨老年股骨颈骨折患者行人工全髋关节置换术与半髋置换术对关节功能恢复的影响。方法选取2018年3月至2020年12月我院收治的老年股骨颈骨折80例患者。根据手术不同使其分成半髋置换组和全髋置换组,每组各40例。比较两组围手术期指标(手术时间、髋关节主动屈曲时间、直腿抬高≥10 cm时间、术后住院时间),对比两组Harris评分、日常生活活动量表(ADL)、视觉模拟疼痛评分(VAS)。结果半髋置换术组手术时间、术后住院时间与全髋置换术组比较更低,差异显著(P<0.05)。治疗后,两组Harris评分、ADL评分较治疗前明显更高(P<0.05)。两组VAS评分组内比较,治疗后14 d<治疗后7 d<治疗前(P<0.05);与全髋置换术组比较,半髋置换术组治疗后7 d VAS评分显著低于全髋置换术组(P<0.05)。结论与全髋关节置换术比较,半髋关节置换术有利于患者术后快速康复,且对术后关节功能及日常活动能力无明显影响,在老年患者中的应用价值较高。

Objective:To investigate the effect of total hip replacement and hemihip replacement on the recovery of joint function in elderly patients with femoral neck fracture.Methods:A comparative study was conducted among the elderly patients with femoral neck fracture in our hospital.All 80 cases were collected from March 2018 to December 2020.According to different operations,they were divided into hemiarthroplasty group and total hip arthroplasty group,with 40 cases in each group.The perioperative indicators and Harris score,ADL and VAS were compared between the two groups.Results:Compared with the total hip replacement group,the operation time and postoperative hospital stay in the hemihip replacement group were significantly lower(P<0.05).After treatment,Harris score and ADL score of the two groups were significantly higher than those before treatment(P<0.05).The VAS scores of the two groups were 14 d<days after treatment<7 d after treatment<before treatment(P<0.05).Compared with the total hip replacement group,the VAS score in the hemihip replacement group was significantly lower than that in the total hip replacement group 7 days after treatment(P<0.05).Conclusion:Compared with total hip replacement,hemiarthroplasty is more suitable for elderly patients,because it is conducive to rapid recovery after operation and has no obvious effect on joint function and daily activities.