全髋和半髋关节置换术在改善股骨颈骨折患者血液流变学指标、髋关节功能方面的效果对比

Effect of Total Hip Arthroplasty and Hemiarthroplasty on Hemorheological Indexes and Hip Joint Function in Patients with Femoral Neck Fracture

目的对比全髋和半髋关节置换术在股骨颈骨折(FNF)患者中的应用效果。方法选取2020年4月-2023年4月台儿庄区人民医院收治的70例FNF患者为研究对象,按随机数字表法将其分为对照组与观察组,各35例。对照组行半髋关节置换术,观察组行全髋关节置换术,术后随访3个月。对比两组围术期指标、血液流变学指标、髋关节功能、生活质量、并发症发生情况。结果观察组术中出血量为(315.97±28.63)mL,多于对照组的(254.21±24.20)mL,手术时间为(123.59±14.36)min,长于对照组的(109.71±10.53)min,并发症发生率为5.71%,低于对照组的22.86%,且观察组术后的髋关节Harris评分量表评分与生活质量综合评定问卷内各维度评分分别为(79.83±6.35)分、(76.96±5.40)分、(78.74±5.29)分、(80.43±4.23)分、(80.63±6.11)分,均高于对照组的(71.24±5.73)分、(69.88±4.15)分、(71.96±4.23)分、(70.58±3.49)分、(71.53±5.36)分,组间差异有统计学意义(P<0.05)。术前、术后,两组全血低切粘度、全血高切粘度相比,组间差异无统计学意义(P>0.05)。结论全髋置换术具有创伤大、术式时间长等缺点,但更能够改善FNF患者髋关节功能,提升生活质量,且并发症较少,且对患者的血液流变学无较多影响,具有一定的应用价值。

Objective To analyze and compare the effects of total hip and semi-hip replacement in patients with femoral neck fracture(FNF).Methods 70 patients with FNF admitted to Taierzhuang District People's Hospital from April 2020 to April 2023 were selected as the research objects.According to the random number table method,they were divided into a control group and an observation group,with 35 cases in each group.The control group was treated with half hip replacement,and the observation group was treated with total hip replacement.The patients were followed up for 3 months.Compared two groups of perioperative indexes,blood rheology indexes,the hip joint function and quality of life,complications.Results The intraoperative blood loss in the observation group was(315.97±28.63)mL,which was more than(254.21±24.20)mL in the control group.The operative time was(123.59±14.36)min,which was longer than(109.71±10.53)min in the control group.The incidence of complications was 5.71%.Lower than 22.86%in the control group,In addition,the scores of Harris hip scale and quality of life questionnaire in the observation group were(79.83±6.35)points,(76.96±5.40)points,(78.74±5.29)points,(80.43±4.23)points and(80.63±6.11)points,respectively,they were higher than(71.24±5.73)points,(69.88±4.15)points,(71.96±4.23)points,(70.58±3.49)points,(71.53±5.36)points of control group,and there were statistical significance between groups(P<0.05).Before and after surgery,there was no significant difference in low and high viscosity of whole blood between the two groups(P>0.05).Conclusion Total hip replacement has disadvantages such as large trauma and long operation time,but it can better improve hip function and quality of life in FNF patients with fewer complications,and has no significant impact on hemorheology of patients,so it has certain application value.