全髋关节置换术治疗老年股骨颈骨折48例临床分析

Clinical analysis of total hip arthroplasty in the treatment of 48 cases of older femoral neck fractures

目的探讨老年股骨颈骨折的最佳手术方式及临床疗效。方法将96例老年股骨颈骨折患者随机分为观察组和对照组,每组各48例,观察组采用全髋关节置换术,对照组采用人工股骨头置换术,比较两组临床疗效及不良反应。结果观察组手术时间短于对照组,两组比较,差异有统计学意义(P<0.05)。观察组术中出血量多于对照组,术后下地活动时间短于对照组,两组比较,差异有高度统计学意义(P<0.01)。观察组优良率为87.50%,对照组优良率为66.67%,两组比较,差异有高度统计学意义(P<0.01)。观察组术后并发症4例(8.33%),对照组术后并发症13例(27.08%),两组比较,差异有统计学意义(P<0.05)。结论人工全髋关节置换术治疗老年股骨颈骨折,能迅速恢复髋关节的正常位置,重建髋关节功能,改善患肢疼痛及功能障碍,避免长期卧床引起的并发症,降低老年股骨颈骨折患者的死亡率,是目前老年股骨颈骨折理想的治疗方法之一。

Objective To investigate the best surgical method and the clinical effects of older femoral neck fracture.Methods 96 cases of older femoral neck fracture were randomly divided into the observation group and the control group,each group had 48 cases respectively.The observation group was implemented total hip arthroplasty（THA）,but the control group was implemented femoral head replacement.Then the clinical effects and adverse reaction（ADR） of the two groups were compared.Results The operation time of the observation group was shorter than that of the control group,the difference was statistically significant（P 0.05）.The amount of bleeding of the observation group was more than that of the control group,but the postoperation activities time of observation group was earlier than that of the control group,there were significant differences between the two groups（P 0.01）.The excellent rate of the observation group was 87.50%,while the control group was 66.67%,after comparison,there was a significant difference between the two groups（P 0.01）.The observation group and the control group had 4 cases（8.33%） and 13 cases（27.08%） of postoperative complications respectively,the two groups had significant differences（P 0.05）.Conclusion THA in the treatment of older femoral neck fractures can recover the normal position of hip joint quickly,rebuild hip joint function,improve limb pain and dysfunction,avoid complications caused by long-term stay in bed and reduce the mortality of older patients with femoral neck fracture,which is one of the excellent and ideal treatment in nowadays.