老年髋部骨折内固定与人工髋关节置换术的临床疗效比较

Clinical curative effect comparison of internal fixation and artificial joint replacement in treating hip fracture in elderly patients

目的对内固定手术与人工髋关节置换术治疗老年髋部骨折的临床疗效进行比较分析。方法笔者回顾分析2010年1月～2013年6月收治的108例老年髋部骨折患者的临床资料，其中48例采用内固定手术（内固定组），60例采用人工髋关节置换术（置换组），对两种手术患者手术时间、术中出血量、术中输血量、术后引流量、负重时间、术后并发症发生率和肢体功能恢复情况进行比较分析。结果置换组患者术中出血量较内固定组明显增加，而在负重时间和并发症的发生率上则明显少于内固定组。置换组术后6、12个月的功能优良率分别为96．7％、90％，内固定组分别为85．4％、77．1％，置换组均明显高于内固定组（P〈0．05），差异具有统计学意义。结论人工髋关节置换术在治疗老年髋部骨折上可有效缩短术后卧床时间，尽早进行负重行走，且其近期疗效也明显优于内固定组，因此人工髋关节置换术可作为老年髋部骨折较理想的手术方法。

Objective To analyze the treatment effect between the internal fixation and artificial joint replacement therapy for the elderly hip fracture. Methods The clinical data of 108 elderly patients with hip fracture who were treated in our hospital from Jan. 2010 to Jun. 2013 were retrospectively analyzed, including 48 cases treated by internal fixation surgery（the internal fixation group）, and 60 cases by artificial hip replacement （the replacement group）. The general condition of the surgery and postoperative recovery of two kinds of surgery were compared and analyzed. Results The bleeding amount of patients in the replacement group was significantly increased than that of patients in the internal fixation group, and the load time and the incidence of complications were obviously less than in the internal fixation group. The overall excellent and good rate of functional recovery in the replacement group was significantly higher than that of the internal fixation group at 6 months and 12 months after surgery（P 〈0. 05） ,the difference was statistically significant. Conclusion The hip arthroplasty in the treatment of senile hip fracture can effectively shorten the patients＇ bed time and result in early load exercise as well as better short-term clinical efficiency than internal fixation. So hip arthroplasty can be used as the preferred treatment for elderly hip fractures.