THR与BFHR治疗高龄股骨颈骨折患者的疗效评价

Efficacy of total hip replacement and bipolar artificial femoral head replacement in the senile patients with femoral neck fracture

目的观察并探讨全髋关节置换和人工双极股骨头置换治疗高龄股骨颈骨折(Femoral neck fracture,FNF)患者的临床疗效。方法选择自2007年8月—2011年5月在绍兴市人民医院接受治疗的FNF患者120例,根据治疗方式的不同将患者分为观察组(THR组)和对照组(BFHR组),THR组60例接受THR方案治疗;而BFHR组60例接受BFHR方案治疗。记录和比较2组患者的手术时间、术中出血量、术中输血量、术后引流量、住院时间、治疗后1年的并发症情况以及术后3年髋关节功能Harris评分,进行相关统计分析。结果 BFHR组的手术时间、术中出血量、术中输血量、术后引流量以及住院时间明显低于THR组,差异具有统计学意义(P<0.05);治疗后1年,BFHR组和THR组的并发症发生率分别为23.3%(14/60)和3.3%(2/60),差异具有统计学意义(P<0.05);治疗后3年,THR组和BFHR组的髋关节功能Harris评分的优良率分别为43.3%(26/60)和15.0%(9/60),差异具有统计学意义(P<0.05)。结论 THR治疗能明显改善患者的股骨颈骨功能,提升患者的生活质量,疗效显著,在临床上值得推广应用。

Objective To compare the efficacy of total hip replacement （THR） with bipolar artificial femoral head re- placement（BFHR） in the treatment of femoral neck fracture（FNF）. Methods A total of 120 patients with FNF in our hospital from August 2007 to May 2011 were selected and divided into observation group （THR group） and control group （BFHR group） according to the different methods of treatment ,with 60 cases in each group. The patients in the observa- tion group accepted total hip replacement, while the control group accepted bipolar artificial femoral head replacement. The operation time, blood loss, blood transfusion, postoperative drainage, hospital stays, 1 year after treatment and postoperative hip function Harris score 3 year after treatment in both groups were documented for statistical analysis. Results In the observation group, the operation time, blood loss, blood transfusion, postoperative drainage, hospital stays were obviously lower than these in the control group, the difference was statistically significant（ P 〈 0.05 ） ; the rates of postoperative com- plication in the control group and the observation group were respectively 23.3% （14/60） and 3.3% （2/60） ,the differ- ence was statistically significant（P 〈0. 05） ;the excellent and good rates of postoperative hip function Harris score in the observation group and the control group were respectively 43.3 % （26/60） and 15.0% （9/60） , the difference was statisti- cally significant（P 〈0.05）. Conclusion BFHR can significantly improve the femoral neck bone function and quality of life for patients with femoral neck fracture, it also with a significant effect, thus it＇ s worth popularization and application in clinic.