全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折的疗效比较

The efficacy comparison of total hip arthroplasty and artificial femoral head prosthetic replacement in the treatment of elderly femoral neck fractures

目的比较全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折的临床疗效。方法将我院2013年3月至2016年3月收治的82例老年股骨颈骨折患者随机分为观察组(全髋关节置换术)和对照组(人工股骨头置换术),每组41例。对比两组患者的髋关节评分(Harris评分)、手术出血量、手术时间、术后引流量、住院时间及术后并发症发生情况。结果观察组患者的Harris评分优良率为82.93%明显高于对照组的70.73%(P<0.05)。观察组患者的手术出血量为(259.21±21.58)m L和术后引流量为(315.11±32.31)m L明显少于对照组的(371.28±22.21)m L及(376.7±21.22)m L(P<0.05)。观察组患者的手术时间为(86.19±6.38)min及住院时间为(22.11±8.11)d明显短于对照组患者的(95.12±11.23)min及(29.28±7.01)d(P<0.05)。观察组患者的并发症发生率为17.07%与对照组的19.51%比较,差异无统计学意义(P>0.05)。结论老年股骨颈骨折应用全髋关节置换术临床疗效优于人工股骨头置换术,术中出血量少,手术时间和住院时间短,且并发症少,有一定的优势,值得临床推广应用。

Objective To compare the efficacy between total hip arthroplasty and artificial femoral head replacement in the treatment of elderly femoral neck fractures. Methods Eighty-two cases of femoral neck fracture patients in our hospital from March 2013 to March 2016 were randomly divided into observation group （total hip arthroplasty） and control group （artificial femoral head prosthetic replacement）, with 41 cases in each group. The rate of Harris score, the amount of bleeding, operation time, postoperative drainage, hospital stay, and postoperative complications of the two groups were compared. Results The excellent rate evaluated by Harris score was 82.93% in observation group, which was significantly higher than 70.73% of the control group （P〈0.05）. In observation group, the amount of operative bleeding was （259.21±21.58） mL and postoperative drainage volume was （315.11±32.31） mL, which were significantly lower than （371.28±22.21） mL and （376.7±21.22） mL in the control group （P〈0.05）; the operation time and hospital stay in observation group were （86.19±6.38） min and （22.11±8.11） d respectively, which were shorter than （95.12±11.23） min and （29.28±7.01） d in the control group （P〈0.05）. The complication rate of the observation group was 17.07% compared with 19.51% in the control group, the difference was not statistically significant （P〉0.05）. Conclusion The clinical efficacy of total hip replacement is better than artificial femoral head replacement in elderly femoral neck fracture, it has less blood loss, shorter operative time and hospital stay and less complications. Owning the above advantages, it is worthy of clinical application.