全髋关节置换术与双极人工股骨头置换术治疗老年股骨颈骨折的临床疗效

Clinical Effects of Total Hip Arthroplasty and Bipolar Hemiarthroplasty on the Treatment of Senile Femoral Neck Fracture for the Elderly Patients

目的:探讨全髋关节置换术(THA)与双极人工股骨头置换术(BHA)治疗老年股骨颈骨折的临床疗效。方法:选择2013年7月-2015年3月我院收治的老年股骨颈骨折患者90例,根据手术方法不同将患者分为全髋关节置换组(THA组)和双极人工股骨头置换组(BHA组),每组45例。观察并比较两组患者的手术时间、术中出血量、住院时间、术后并发症的发生率及手术效果。结果:两组患者的手术时间、术中出血量及住院时间比较,差异无统计学意义(P>0.05);THA组并发症的发生率明显低于BHA组,差异具有统计学意义(P<0.05);术后1年,两组手术优良率比较,差异无统计学意义(P>0.05);术后两年及三年,THA组手术优良率明显高于BHA组,差异具有统计学意义(P<0.05)。结论:THA和BHA治疗老年股骨颈骨折均具有良好的临床疗效,但THA具有更好的远期疗效,而且术后并发症的发生率较低。

Objective： To compare the clinical curative effect of total hip arthroplasty（THA） and bipolar hemiarthroplasty（BHA）on the treatment of senile femoral neck fracture for elderly patients. Methods： 90 elderly patients with femoral neck fracture who were treated in our hospital from July 2013 to March 2015 were selected, and according to the different treatment methods, the patients were divided into the total hip arthroplasty group（THA） and the bipolar hemiarthroplasty group（BHA）, with 45 cases in each group. Then the operation time, the intraoperative blood loss, the hospitalization, the incidence of postoperative complications and the clinical effects in the two groups were observed and compared. Results： There was no statistically significant difference about the operation time, the intraoperative blood loss and the hospitalization of the patients in the two groups（P〈0.05）; The incidence of postoperative complications in the THA group was lower than that of the BHA group（P〈0.05）; There was no statistically significant difference about the clinical effects in the two groups after the treatment for one year（P〈0.05）; The clinical effects in the THA group after the treatment for two and three years were significantly higher than those of BHA group, and the differences were statistically significant（P〈0.05）. Conclusion：THA and BHA have a good clinical efficacy on the treatment of senile femoral neck fracture for elderly patients, and THA is better for a long-term curative effect and lower postoperative complications.