老年髋部骨折内固定与人工髋关节置换术的临床对比研究

Comparative study of internal fixation and artificial hip replacement in elderly patients with hip fracture

目的对比骨折内固定与人工髋关节置换术治疗老年髋部骨折的临床疗效分析。方法选取我院2013年1月至2016年1月期间收治的90例老年髋部骨折患者作为本研究对象,按随机数字表的方法分为观察组(n=45)和对照组(n=45),对照组患者使用内固定手术进行治疗,观察组患者使用人工髋关节置换术进行治疗,分别对两组患者的手术相关指标和Harris髋关节功能评分进行比较,并对两组患者术后的视觉模拟评分法(VAS)进行比较。结果经比较,对照组患者的手术时间和术中出血量等指标明显优于观察组的患者(P<0.05),但观察组患者的术后下地锻炼时间明显更短于对照组(P<0.05);观察组的疼痛、关节活动度、畸形、关节功能等髋关节评分亦优于对照组患者(P<0.05);两组患者术后1 d时的VAS评分差异无统计学意义(P>0.05),但观察组的术后7 d时的VAS评分更优于对照组(P<0.05)。结论骨折内固定与人工髋关节置换术均为治疗老年髋部骨折的有效治疗方法,但人工髋关节置换术提高患者髋关节功能的有效性更为明显,且近期疗效也更优,其可作为治疗老年髋部骨折的理想手术方法。

Objective： to contrast the fracture internal fixation with hip arthroplasty for the treatment of senile hip frac- ture clinical curative effect analysis. Methods： our hospital between January 2013 and January 2016 admitted during the pe- riod of 90 elderly patients with hip fracture as the research object, according to random number table method divided into observation group （ n = 45 ） and the control group （ n = 45 ）, the control group of patients with internal fixation surgery treat- ment, observation group patients with hip arthroplasty for treatment, Respectively on two groups of patients＇indicators relat- ed to the operation and function of Harris hip scores are compared, and the two groups of patients with a one-year follow- up, compare the situation of fracture healing in patients. Results ： by comparison, the control group in patients with opera- tive time and intraoperative blood loss index is better than patients in theobservation group （P 〈 0. 05 ）, but the above obser- vation group of patients with postoperative exercise time significantly shorter than the control group （P 〈 0. 05 ） ;Two groups of patients with postoperative VAS score of 1 d no statistically significant difference （P 〉 0. 05）, but the observation group after 7 d the VAS score when more is better than that of control group（P 〈0. 05）. Conclusions： internal fixation offraeture and hip arthroplasty is an effective method for the treatment of senile hip fracture, but in order to increase the effectiveness of the hip joint function in patients with hip arthroplasty is more apparent, and the recent curative effect is better, it can be used as ideal surgical method for the treatment of senile hip fracture.