微创全髋置换术治疗老年人股骨颈骨折的循证医学研究．

Study on evidence based medicine of minimally invasive total hip arthroplasty on elder femoral neck fracture

目的应用骨科循证医学方法评价微创全髋置换术治疗老年股骨颈骨折的临床效果，为临床治疗策略提供依据。方法采用临床病例与现有的循证医学证据讨论微创全髋置换术治疗老年人股骨颈骨折，临床病例选择该院（病例不足部分从同级医院筛查补充）2009年7月至2012年12月确诊为老年股骨颈骨折患者，并行全髋关节置换术患者200例，按手术方法不同分为微创手术组100例和对照组100例，对临床证据进行验证。结果PubMed上检索相关老年股骨颈骨折微创髋关节置换手术的文章171篇，符合纳入标准16篇。微创组组手术时间（54．9±13．9）min、出血量（275±83）m1、引流量（160±64）ml、切口长度（7．8±1．4）cm、术后并发症0例，均显著优于对照组（t=4．58、3．79、3．24、3．67，均P〈0．05）。结论微创全髋置换术治疗老年股骨颈骨折疗效好、手术时间短、创伤小，且得到循证医学支持。

Objective To evaluate the clinical effects of minimally invasive total hip arthroplasty on elder femoral neck fracture, and supply a basis for clinical therapy. Methods Clinical cases and evidence based medicine were combined to discuss the therapeutic effect of minimally invasive total hip arthroplasty on elder femoral neck frac- ture. 200 patients from July 2009 to December 2012 in our hospital were collected and divided into minimally invasive group and control group,each group had 100 cases. Results The PubMed retrieved 171 articles about femoral neck fracture by minimally invasive hip replacement operation, 16 articles met the inclusion criteria. In minimally invasive group, the operation time was （ 54.9 ±13.9 ） rain, blood loss was （ 275 ± 83 ） ml, drainage flow was （ 160 ±64 ） ml, the length of incision was （7.8± 1.4） era, and no complications occurred after operation, which were significantly better than those in the control group （ t = 4.58,3.79,3.24,3.67, all P 〈 0.05 ）. Conclusion Minimally invasive total hip arthroplasty in the treatment of elder femoral neck fracture has good clinical effect, has advantages of short operation time and minimal trauma.