全髋关节置换术联合抗骨质疏松药治疗老年股骨颈骨折的效果

Clinical efficacy of total hip arthroplasty combined with anti-osteoporosis drugs treatment for femoral neck fracture in elderly patients

目的探讨全髋关节置换术联合抗骨质疏松药治疗老年股骨颈骨折的效果。方法将河北省唐山市中医医院2010年3月~2013年12月收治的63例移位型股骨颈骨折的老年患者分为治疗组（31例）和对照组（32例）。两组均行全髋关节置换术,治疗组术后给予抗骨质疏松治疗。观察两组患者的手术时间、术中出血量、住院时间、骨密度及术后半年髋关节功能恢复情况。结果两组患者的手术时间、术中出血量比较差异无统计学意义（均P〉0.05）。治疗组住院时间为（21.0±6.0）d,对照组为（35.9±5.8）d,两组比较差异有统计学意义（P〈0.05）。治疗组术后3个月L2~4椎体骨密度为（0.65±0.02）g/cm2,对照组为（0.60±0.04）g/cm2,两组比较差异有统计学意义（P〈0.05）。治疗组术后半年髋关节功能优良率为96.8%,对照组为84.3%,两组比较差异有统计学意义（P〈0.05）。结论全髋关节置换术联合抗骨质疏松药治疗老年股骨颈骨折效果较好,患者住院时间短,髋关节功能恢复情况良好,值得临床推广应用。

Objective To investigate the clinical effect of total hip arthroplasty combined with anti-osteoporosis drug treatment for femoral neck fracture in elderly patients.Methods 63 cases of elderly patients with displaced femoral neck fracture were selected as subjects,who were hospitalized in Tangshan Traditional Chinese Medicine Hospital from March 2010 to December 2013.They were divided into the treatment group（31 cases） and control group（32 cases）.All patients were treated with total hip arthroplasty.The patients in the treatment group were given the anti-osteoporosis therapy.The duration of operation,intraoperative blood loss,length of hospital stay,bone mineral density and the recovery of hip function half a year after operation were recorded.Results The duration of operation,intraoperative blood loss in patients of the two groups had no significant differences（P〉0.05）.The length of hospital stay in treatment group was（21.0±6.0）d,which was shorter than that in the control group [（35.9±5.8）d],the difference was statistically significant（P〈0.05）.The bone mineral density of L2-4in the treatment group was（0.65±0.02） g/cm2,which was higher than that in control group [（0.60 ±0.04）g/cm2] in third months after operation and there was significant difference between the two groups（P〈0.05）.The excellent rate of hip joint function in treatment group（96.8%） was superior to that in the control group（84.3%） half a year after operation and the difference was statistically significant（P〈0.05）.Conclusion The effect of total hip arthroplasty combined with anti-osteoporosis drugs treatment for femoral neck fracture in elderly patients is good,which has shorter hospital stay and good hip joint function recovery.It is worthy of clinical application.