人工股骨头置换术与全髋关节置换术治疗骨质疏松性股骨颈骨折221例临床疗效对比研究

Clinical study of artificial femoral head replacement and total hip arthroplasty in the treatment of 221 cases of femoral neck fracture with osteoporosis

目的:探讨人工股骨头置换术与全髋关节置换术治疗骨质疏松性股骨颈骨折患者的临床疗效。方法:选择骨质疏松性股骨颈骨折患者221例,将其随机分为观察组(n=111)和对照组(n=110)两组。观察组采用人工股骨头置换术治疗,对照组采用全髋关节置换术治疗。观察比较两组患者的手术时间、术中出血量、住院时间及下地时间,记录两组患者不良反应发生情况,比较术后6个月Harris评分。结果:观察组手术时间和下地时间分别为(77.34±8.61)min和(12.29±2.18)d,明显低于对照组(120.35±9.48)min和(13.37±2.88)d;观察组术中出血量(237.11±53.26)ml,少于对照组(358.94±62.27)ml,两组比较差异均有统计学意义(P<0.05)。术后6个月,观察组髋关节功能优良率84.68%,低于对照组96.36%;两组Harris评分比较,差异有统计学意义(P=0.000)。两组不良反应发生率比较差异无统计学意义(P=0.360)。结论:人工股骨头置换术适用于高龄且身体综合情况较差者,全髋关节置换术适用于生活质量较高者。

Objective： This study aims to investigate compare the clinical curative effect of artificial femoral head replacement and total hip arthroplasty in the treatment of 221 cases of femoral neck fracture with osteoporosis.Methods： 221 cases of femoral neck fracture with osteoporosis were randomly divided into observation group （n=111） and control group （n=110）.The observation group was treated with artificial femoral head replacement;the control group was treated by total hip arthroplasty.It recorded the operation time, bleeding during the operation, hospitalization time, ambulation time and the adverse reactions.It also compared Harris score after the 6th month.Results： In the observation group, the operation time and ambulation time were（77.34±8.61）min and（12.29±2.18）d, which was significantly lower than those of（120.35±9.48）min and（13.37±2.88）d in the control group.The bleeding during the operation was（237.11±53.26）ml in the observation group, which was less than that of （358.94±62.27） ml in the control group showing a statistically significant difference between the two groups （P＆lt;0.05）.6th month after surgery, the excellent rate of hip joint function in observation group was 84.68%, which was lower than that of 96.36% in the control group;and when compare the Harris scores of the two groups, the difference had a statistically significant （Z=-5.353, P=0.000）.The incidence of adverse reactions was no significant difference when compare the two groups （Х^2=0.838, P=0.360）.Conclusion： The artificial femoral head replacement is suitable for the elderly and poor comprehensive body, and the total hip arthroplasty is suitable for higher quality of life.