摘要
目的探讨半髋与全髋关节置换术(THR)在老年股骨颈骨折(FNF)患者中的应用效果。方法选取2020年6月—2022年6月我院收治的86例老年FNF患者为研究对象,按随机数字表法分为两组,每组43例。对照组行半髋关节置换术,观察组行THR,术后均随访6个月。比较两组患者的手术效果及并发症发生情况。结果观察组的手术时间、住院时间分别为(102.41±10.31)min、(13.89±1.42)d,均长于对照组的(82.74±6.82)min、(12.04±1.25)d,术中出血量、术后引流量分别为(372.58±40.16)mL、(175.63±11.32)mL,均多于对照组的(253.47±29.85)mL、(139.58±10.81)mL,组间差异有统计学意义(P<0.05)。术后6个月,观察组的关节功能、畸形、疼痛程度、关节活动度评分及Harris总评分分别为(39.49±3.72)分、(3.02±0.39)分、(34.96±4.12)分、(3.92±0.45)分、(81.39±5.53)分,均高于对照组的(35.39±3.57)分、(2.62±0.34)分、(31.28±3.93)分、(3.11±0.41)分、(72.40±5.42)分,组间差异有统计学意义(P<0.05)。术后6个月,观察组的世界卫生组织生活质量评定量表简表中生理、心理、社会及环境领域评分分别为(87.54±6.05)分、(88.41±6.12)分、(90.41±4.35)分、(89.84±5.32)分,均高于对照组的(82.03±5.46)分、(81.39±5.74)分、(83.79±5.45)分、(82.57±5.22)分,组间差异有统计学意义(P<0.05)。两组的并发症发生率比较,差异无统计学意义(P>0.05)。结论半髋关节置换术及THR在老年FNF患者中均具有良好效果,其中半髋关节置换术手术创伤更小,术中出血量更少,而THR更有利于患者术后髋关节功能恢复。
Objective To investigate the effect of half hip and total hip replacement(THR)in elderly patients with femoral neck fracture(FNF).Methods 86 elderly patients with FNF admitted to the hospital from June 2020 to June 2022 were selected as the research objects and were divided into two groups according to random number table method,with 43 cases in each group.The control group received half hip replacement,the observation group received THR,and both groups were followed up for 6 months.The operative effect and complications were compared between the two groups.Results The operation time and hospital stay in the observation group were(102.41±10.31)min and(13.89±1.42)d,respectively,which were longer than(82.74±6.82)min and(12.04±1.25)d in the control group,while the intraoperative blood loss and postoperative drainage volume were(372.58±40.16)mL and(175.63±11.32)mL,respectively,which were more than(253.47±29.85)mL and(139.58±10.81)mL in the control group,and the differences between the groups were statistically significant(P<0.05).After 6 months of surgery,the joint function,deformity,pain degree,joint motion score and Harris total score in the observation group were(39.49±3.72)points,(3.02±0.39)points,(34.96±4.12)points,(3.92±0.45)points and(81.39±5.53)points,respectively,which were higher than(35.39±3.57)points,(2.62±0.34)points,(31.28±3.93)points,(3.11±0.41)points,(72.40±5.42)points in the control group,and the differences between the groups were statistically significant(P<0.05).After 6 months of surgery,the physiological,psychological,social and environmental scores of the World Health Organization quality of life-BREF scale in the observation group were(87.54±6.05)points,(88.41±6.12)points,(90.41±4.35)points and(89.84±5.32)points,respectively,which were higher than(82.03±5.46)points,(81.39±5.74)points,(83.79±5.45)points and(82.57±5.22)points in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Both half hip replacement and THR have good results in elderly patients with FNF.Half hip replacement has less trauma and less intraoperative blood loss,and THR is more conducive to the recovery of hip function.
作者
倪和悟
李德
赵延雷
李钦柱
王世金
NI Hewu;LI De;ZHAO Yanlei;LI Qinzhu;WANG Shijin(1st Department of Orthopedics,Jinan Integrated Traditional Chinese and Western Medicine Hospital,Jinan Shandong,250000,China)
出处
《反射疗法与康复医学》
2023年第9期114-117,共4页
Reflexology And Rehabilitation Medicine