人工关节置换术对老年髋部骨折患者髋关节功能康复的影响

Effect of Artificial Joint Replacement on Functional Rehabilitation of Hip Joint in Elderly Patients with Hip Fracture

目的探究人工关节置换术对老年髋部骨折患者髋关节功能康复的影响.方法选取2018年9月—2020年10月本院收治的68例老年髋部骨折患者为研究对象,按照随机数字表法将其分为两组.甲组34例行内固定治疗,乙组34例行人工关节置换术,均从入院观察至出院,并随访6个月.比较两组的手术相关指标、Harris髋关节功能评分及术后并发症发生率.结果两组的手术时间、术后引流量比较,差异无统计学意义(P>0.05);乙组的术后下地锻炼时间为(6.58±1.14)d、术后首次负重时间为(8.35±1.25)d、住院时间为(11.54±2.14)d,均明显短于甲组的(15.17±2.04)d、(38.62±2.98)d、(16.27±2.05)d,组间差异有统计学意义(P<0.05).术前,两组的Harris髋关节功能评分比较,差异无统计学意义(P>0.05);术后3、6个月,乙组的Harris髋关节功能评分均显著高于甲组,组间差异有统计学意义(P<0.05).乙组的并发症发生率为5.88%,明显低于甲组的23.52%,差异有统计学意义(P<0.05).结论老年髋部骨折患者行人工关节置换术的临床疗效良好,相较于内固定治疗可降低并发症发生率,缩短患者住院时间,促进患者早日康复.

Objective To investigate the effect of artificial joint replacement on hip functional rehabilitation of elderly patients with hip fracture.Methods A total of 68 elderly patients with hip fracture admitted to the hospital from September 2018 to October 2020 were selected as the research objects.According to random number table method,the patients were divided into two groups.34 patients in Group A received internal fixation and 34 patients in Group B received artificial joint replacement.All patients were observed from admission to discharge and followed up for 6 months.The surgical indicators,Harris hip function score and incidence of postoperative complications were compared between the two groups.Results There were no significant differences in operation time and postoperative drainage between the two groups(P>0.05);the postoperative ground exercise time of Group B was(6.58±1.14)d,the postoperative first weight-bearing time was(8.35±1.25)d,the hospital stay time was(11.54±2.14)d,which were significantly shorter than(15.17±2.04)d,(38.62±2.98)d,(16.27±2.05)d of Group A,the differences between groups were statistically significant(P<0.05).The preoperative Harris hip function scores of the two groups showed no significant difference(P>0.05);at 3 and 6 months after surgery,the Harris hip function scores of Group B were significantly higher than those of Group A,the differences between groups were statistically significant(P<0.05).The complication rate of Group B was 5.88%,which was significantly lower than 23.52%of Group A,the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of artificial joint replacement in elderly patients with hip fracture is good.Compared with internal fixation,it can reduce the incidence of complications,shorten the length of hospital stay and promote the early recovery of patients.