骨水泥型与生物型髋关节置换术治疗股骨颈骨折对术后关节疼痛的影响

Effect of Bone Cement Type and Biological Type Hip Replacement on Postoperative Joint Pain of Transcervical Fracture

目的:探讨骨水泥型与生物型髋关节置换术治疗股骨颈骨折对术后患者关节疼痛的影响。方法:回顾性分析2012年2月-2013年8月我院收治的股骨颈骨折患者的临床病历资料,按照假体类型将其分为骨水泥型髋关节置换术(A组)和生物型髋关节置换术(B组),通过Harris与分项百分制髋关节疼痛评分比较两组患者术后髋关节的疼痛情况。结果:两组患者的手术时间、术中出血量以及术后引流量比较,差异无统计学意义(P>0.05),A组的住院时间短于B组,差异有统计学意义(P<0.05)。A组术后3、6个月的髋关节疼痛率均低于B组,术后12、24个月则高于B组,差异有统计学意义(P<0.05);经x2趋势分析,A组患者术后髋关节疼痛率随时间增加呈逐渐上升趋势,差异有统计学意义(x2=10.837,P=0.001),B组患者术后髋关节疼痛率随时间增加呈逐渐下降趋势,差异有统计学意义(x2=9.842,P=0.002)。A组患者术后3、6个月的髋关节疼痛评分高于B组,术后12、24个月则低于B组,差异有统计学意义(P<0.05);A组术后3、6个月的髋关节疼痛评分高于术后12、24个月,B组3、6个月的髋关节疼痛评分低于术后12、24个月,差异有统计学意义(P<0.05)。结论:骨水泥型假体缓解髋关节疼痛近期效果优于生物型假体,而生物型假体远期效果优于骨水泥型假体。

Objective： To explore the effect of bone cement type and biological type hip replacement on postoperative joint pain of transcervical fracture. Methods： The clinical data of patients with transcervical fracture, who were admitted to Beijing Haidian Hospital from February 2012 to August 2013, were retrospectively analyzed. The patients were divided into bone cement type hip replacement（group A） and biological type hip replacement（group B） by the prosthesis type. The postoperative pain of hip joint of patients in the two groups was compared by the Harris and the partial percentage of hip pain score. Results： There were no statistical significance in the operation time, bleeding volume and postoperative drainage volum between the two groups（P〉0.05）. The hospitalization time of group A was shorter than that of group B, the difference was statistically significant（P〈0.05）. The incidence of hip pain of group A was lower than that of group B 3 and 6 months after operation, but higher than that of group B 12 and 24 months after operation, the differences were statistically significant（P〈0.05）. By the x2 trend analysis, the incidence of hip pain of group A showed a gradual upward trend along with the increase of time after operation, the difference was statistically significant（x2=10.837, P=0.001）, while the incidence of hip pain of group B showed a gradual downward trend along with the increase of time after operation, the difference was statistically significant（x2=9.842,P=0.002）. The hip pain scores of group A were higher than those of group B 3 and 6 months after operation,but lower than those of group B 12 and 24 months after operation, the differences were statistically significant（P〈0.05）. The hip pain scores of group A 3 and 6 months after operation were higher than 12 and 24 months after operation, and the hip pain scores of group B 3 and 6 months after operation were lower than 12 and 24 months after operation, the differences were statistically significant（P〈0.05）. Conclusion： The short-term effect of bone cement prosthesis in relieving the pain of hip joint is better than biological prosthesis, but the long-term effect of biological prosthesis is better than bone cement prosthesis.