全髋关节与半髋关节置换术治疗老年股骨颈骨折的效果比较

Comparison of effects of total hip arthroplasty and half hip arthroplasty on femoral neck fracture in elderly

目的对比全髋关节与半髋关节置换术治疗对老年股骨颈骨折的效果及对术后髋关节功能的影响。方法选取2016年3月至2017年6月阳泉市第一人民医院就诊的老年股骨颈骨折患者92例,根据随机数表法分为A组和B组,每组46例。A组采用全髋关节置换术,B组采用半髋关节置换术,对比两组围术期指标、髋关节评分量表(Harris)评分及并发症情况。结果B组术中出血量、总引流量少于A组,手术时间、拔管时间短于A组,完全负重时间较长,差异有统计学意义(P<0.05);A组术后6、12个月Harris评分均高于B组,差异有统计学意义(P<0.05);A组并发症发生率明显低于B组,差异有统计学意义(P<0.05)。结论半髋关节置换术可有效缩短老年股骨颈骨折患者手术时间及拔管时间,减少术中出血量,患者耐受性较好;而全髋关节置换术可更好地恢复患者髋关节功能,减少并发症发生。

ObjectiveTo compare the effects of total hip arthroplasty (THA) and hemiarthroplasty (HA) on hip function on elderly patients with femoral neck fracture and the hip function after operation.MethodsA total of 92 elderly patients with femoral neck fracture admitted in the First People's Hospital of Yangquan from March 2016 to June 2017 were selected. According to the random number table method, they were divided into group A and group B, with 46 patients in each group. Total hip arthroplasty was used in group A and half hip arthroplasty was used in group B. Perioperative indicators, hip score (Harris hip score) and complications were compared between the two groups.ResultsThe bleeding volume and total drainage volume in group B were significantly less than those in group A, the operation time and extubation time were shorter than those in group A, and the total weight-bearing time was longer (P<0.05). Harris score in group A was higher than that in group B at 6 months and 12 months after operation (P<0.05), and the incidence of complications in group A was significantly lower than that in group B (P<0.05).ConclusionsHalf hip arthroplasty can effectively shorten the operation time and tube removal time of elderly patients with femoral neck fracture, reduce the intraoperative blood loss, and the patient has good tolerance. Total hip replacement can better restore hip function and reduce the complications.