双极人工股骨头置换治疗老年不稳定股骨粗隆间骨折的疗效评价

Effect of bipolar artificial femoral replacement on treatment of elderly patients with unstable femoral intertrochanteric fracture

目的探讨老年不稳定股骨粗隆间骨折患者行双极人工股骨头置换术的临床疗效。方法将162例患者随机分为BHR组和DHS组,每组81例。BHR组采用双极人工股骨头置换术治疗,DHS组采用股骨动力髋螺钉内固定术治疗,对2组术中相关指标及术后随访结果进行比较分析。结果 BHR组优良率为86.42%,显著高于DHS组的76.54%(Riditz=26.348,P=0.000);BHR组手术时间、术后Harris评分均长于、大于DHS组,失血量和下地时间小于、短于DHS组,差异均有统计学意义(P<0.05);DHS组并发症发生率为16.05%,再手术率为4.94%,而BHR组并发症发生率为3.70%,无再次手术患者,2组差异有统计学意义(P<0.05)。结论与股骨动力髋螺钉内固定术治疗相比,双极人工股骨头置换术后并发症少,治疗效果显著,值得临床推广。

Objective To explore the therapeutic effect of bipolar artificial femoral replacement on the treatment of elderly patients with unstable femoral intertrochanteric fracture.Methods 162 patientswere randomly divided into BHRgroup and DHS group,81 casesin each group. The BHR group was treated with treat bipolar artificial femoral replacement, while the DHS group was treated with femoral dynamic hip screw fixation. Correlative indexes and result of follow up were analyzed and compared between two groups.Results The excellent rate in the BHR group was86.42%,whichwassignificantlyhigherthan76.54%intheDHSgroup（Ridit,z= 26.348,P=0.000）. The operation time and Harris score in the BHRgroup were significantly longer and higher than those in the DHS group, and blood loss and ambulation time were significantly less and shorter than those in the DHS group（P 0.05）. The incidence rate of complications and reoperation rate inthe DHS group was1 6.0 5% and 4.9 4% respectively,which were significantly higher than3.70% and 0.00% in the BHRgroup（P 0.05）.Conclusion Compared with the DHS therapy,the BHR therapy can reduce the incidence rate of postoperative complications and effectively enhance the therapeutic efficacy, so it is worthy of clinical application.