人工股骨头置换术与全髋关节置换术治疗老年人股骨颈骨折的临床对比研究

Clinical Studies of Artificial Femoral Head Replacement and Total Hip Replacement for Femoral Neck Fractures in the Elderly Patients

目的比较人工股骨头置换术与全髋关节置换术治疗老年人股骨颈骨折的疗效。方法将2006年11月至2013年11月北京市大兴区红星医院骨外科诊断为股骨颈骨折的老年患者86例,依据随机数字表法分为观察组和对照组,各43例,分别予以全髋关节置换术和人工股骨头置换术。记录并观察两组患者Harris评分、手术时间、术中出血量、术后引流量及术后并发症情况。结果1与对照组比较,观察组手术时间较长、术中出血量较多,差异有统计学意义(P<0.01),两组术后引流量比较差异无统计学意义(P>0.05)。2观察组早期并发症发生率为4.9%,低于对照组的18.6%,差异有统计学意义(χ2=4.07,P<0.05)。3观察组Harris评分优良率高于对照组,差异有统计学意义(Z=2.326,P<0.05)。结论对老年人股骨颈骨折患者应当结合其自身条件,合理选择人工股骨头置换或全髋关节置换术治疗,以减少股骨颈骨折严重并发症的发生,提高患者生活质量。

Objective To compare the effect of artificial femoral head replacement and total hip replacement on femoral neck fracture. Methods A total of 86 patients with femoral neck fracture admitted to the Beijing Daxing District Hongxing Hospital from Nov. 2006 to Nov. 2013 were randomly divided into two groups. 43 patients in the observation group were treated with total hip replacement surgery,and 43 patients in the control group were treated by artificial femoral head replacement. The Harris ratings,the operation time,bleeding,postoperative drainage,and incidence of complications of the two groups were observed and compared. Results 1 Compared with the control group,the operation time was longer and bleeding was greater in the observation group,the difference was statistically significant（ P 〈0. 01）,postoperative drainage between the two groups showed no significant difference（ P 〈0. 05）. 2Early complications incidence of the observation group was 4. 9%,of the control group was 18. 6%,the difference was statistically significant（ χ2= 4. 07,P 〈0. 05）. 3Compared to the control group,the observation group＇ Harris excellent rate was higher,the difference was statistically significant（ Z = 2. 326,P 〈0. 05）. Conclusion Reasonable choice of artificial femoral head replacement or total hip replacement surgery should be made for the elderly patients with femoral neck fracture according to the patients＇ condition,so as to reduce the incidence of serious complications of femoral neck fractures and improve the quality of life of the patients.