全髋关节置换术和人工股骨头置换术治疗老年股骨颈骨折的疗效比较

The Curative Effect Comparison of Total Hip Replacement and Artificial Femoral Head Replacement in the Treatment of Senile Femoral Neck Fracture

目的:探讨全髋关节置换术和人工股骨头置换术在治疗老年股骨颈骨折中的疗效差别。方法:选取笔者所在医院老年股骨颈骨折患者176例,随机分为试验组和对照组,试验组使用全髋关节置换术治疗,对照组使用人工股骨头置换术治疗,观察对比两组手术时间、术后出血量、术后引流量、住院时间以及两组Harris评分和优良率。结果:试验组手术时间明显长于对照组,术后出血量和术后引流量较对照组多,两组比较差异有统计学意义(P<0.05),试验组住院时间长于对照组,两组比较差异有统计学意义(P<0.05)。术后1年试验组和对照组的Harris评分以及优良率比较差异无统计学意义(P>0.05),但在术后3年和术后5年两组Harris评分以及优良率比较,试验组明显高于对照组,差异有统计学意义(P<0.05)。结论:两种术式各有优点,人工股骨头置换术创伤小、手术时间短、出血量和术后引流量较少、住院时间短,但全髋关节置换术在远期疗效上要优于人工股骨头置换术。

Objective：To study the curative effect difference of artificial femoral head replacement and total hip replacement in the treatment of senile femoral neck fracture.Method：176 cases of elderly patients with femoral neck fracture in our hospital were randomly divided into experimental group and control group,experimental group treated with total hip replacement,and the control group used artificial femoral head replacement treatment,the operation time, blood loss,postoperative flow rate,length of hospital stay and postoperative Harris score in the two groups were compared.Result：The operation time in the experimental group was significantly longer than that in the control group,postoperative blood loss and postoperative flow in the experimental group were more than that in the control group,the differences between the two groups were statistical significance（P〈0.05）,the hospital stay in the experimental group was longer than that in the control group,the difference was statistically significant（P〈0.05）.After 1 year,the postoperative Harris rating of the experimental group compared with the control group was no significant difference（P〉0.05）,but after 3 years and 5 years,postoperative Harris rating and good ratings in the experimental group were significantly higher than that in the control group,the differences were statistically significant（P〈0.05）.Conclusion：The two kinds of operative methods have their own advantages,artificial femoral head replacement are small trauma,shorter operation time,less blood loss and postoperative led traffic,and shorter hospitalization time,but the total hip replacement on the long-term curative effect is more superior than the artificial femoral head replacement.