全髋与半髋关节置换术治疗老年人股骨颈骨折疗效对比

Comparison of total hip and hip arthroplasty in the treatment of femoral neck fracture in the elderly

目的研究全髋与半髋关节置换术治疗老年人股骨颈骨折的疗效对比。方法选取我院2013年6月至2015年6月期间接诊的220例老年股骨颈骨折患者，将其进行随机分组，半组患者110例，采取半髋关节置换术；全组患者110例，采取全髋关节置换术，对比两组患者治疗后的临床结果，分析两组患者治疗后的不良反应情况及术后1年随访的结果评分。结果①两组患者在手术时间、术中出血量、以及术后住院时间等方面，半组手术患者的各项指标分别为，（88．92±0．82）min，（325．04±45．22）ml，住院时间（19．05±2．52）d，均低于全组手术患者（i01．33±11．52）min，（452．88±55．13）ml，（24．51±2．92）d，经比较P〈0.05；②两组患者在髋关节功能恢复时间、并发症以及疼痛率等方面比较，半组患者分别为（23±5）d，20．9％（23／1i0），26．4％（29／110），均高于全组患者（17±4）d，13．6％（15／110），18．2％（20／110），经比较P〈0.05；③通过治疗试验对比，两组患者术后1年随访结果评分，半组患者优良率78．2％，全组患者优良率90．9％，经分析P〈0.05，有显著差异。结论全髋与半髋置换术对老年股骨颈骨折均有良好的疗效，能够有效的满足患者基本的治疗结果，但在降低并发症，疼痛率及术后优良评分等方面全髋关节置换术更具优势，可以作为治疗老年股骨颈骨折的首选方式，可进行临床推广普及。

Objective To compare the curative effect of total hip and hip arthroplasty in the treatment of femoral neck fracture in the elderly. Methods Were selected from our hospital in June 2013 to 2015 June during the admissions of 220 cases of elderly patients with femoral neck fracture patients, which were divided randomly into two groups, semi group of 110 patients, take half hip arthro plasty; 110 cases of all patients, to take total hip arthroplasty, the clinical outcome of patients in two groups after treatment were corn pared and analysis after treatment in two groups of patients with adverse reactions and postoperative 1 year follow up results score. Results ①Patients in the two groups in the operation time, intraoperative bleeding, and postoperative hospitalization time aspects, semi group of patients who underwent surgical indicators respectively（88. 92 ± 10.82） min, 325.04 ± 45. 22） ml, hospitalized time （19. 05±2.52） d, were lower than the operative patients （10. 133±11.52） min, 452. 88±55.13） ml, 24. 515±2. 92） d, by comparison, P〈0.05. ②Two groups of patients in the hip joint function recovery time, complications and pain rate comparison, semi groups respectively （23±5） d, 20.9% （23/110）, 26.4% （29/110）, were higher than in all patients （17±4） d, 13.6% （15/110）, 18.2% （20/110）. By comparison, P〈0.05. ③Through the treatment test, two groups of patients after 1 year follow-up results score, the excellent and good rate was 78.2%, the excellent rate of the whole group was 90.9%, the analysis of P〈0.05, there was a significant difference. Conclusion Total hip replacement and hemiarthroplasty for elderly patients with femoral neck fracture has good curative effect, can effectively meet the needs of patients the basic treatment outcome, but in reducing complications, pain rate and postoperative excellent scores on total hip arthroplasty has more advantages, as the preferred method of treatment of senile femoral neck frac ture, clinical popularization.