髋关节置换术与骨折内固定术对老年股骨颈骨折患者的疗效及Harris评分的影响

Curative effect of hip replacement and fracture internal fixation to elderly patients with femoral neck fracture and the impact of the Harris score

目的研究对比髋关节置换术与骨折内固定术对老年股骨颈骨折患者的疗效及Harris评分的影响。方法选取2015年2月~2016年2月我院收治的老年股骨颈骨折患者90例。以随机数字表法分成观察组与对照组各45例。对照组予以骨折内固定术治疗,观察组则行髋关节置换术治疗。分别比较两组疗效,治疗前后Harris评分,手术情况,并发症发生率以及再手术率。结果观察组治疗后优良率为88.89%(40/45),高于对照组的68.89%(31/45),差异有统计学意义(P<0.05)。治疗后观察组与对照组Harris评分分别为(87.3±10.4)、(77.2±8.7)分,均高于治疗前,而观察组又高于对照组,差异具有统计学意义(P<0.05)。观察组手术时间、出血量及住院时间均高于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率及再手术率分别为4.44%(2/45)、2.22%(1/45),均低于对照组的22.22%(10/45)、15.56%(7/45),差异有统计学意义(P<0.05)。结论骨折内固定术治疗老年股骨颈骨折的创伤更小,有利于促进患者早日康复,而髋关节置换术的临床疗效更加显著,有效促进患者髋关节功能的恢复,更适合老年患者。

Objective To explore the effect of hip replacement and fracture internal fixation to elderly patients with femoral neck fracture and the impact of the Harris score. Methods 90 cases of senile femoral neck fracture treated in our hospital from February 2015 to February 2016 were selected and randomly divided into observation group and control group with 45 cases in each according to random digital table method. Patients in control group were treated with internal fixation,and patients in observation group were treated with total hip replacement.Curative effect,Harris score,operation,complication rate and reoperation rate before and after treatment of the two groups were compared. Results The excellent and good rate of the observation group was 88.89% （40/45）,which was higher than that of the control group 68.89% （31/45）,there was a significant difference （P 〈 0.05）.After treatment,the Harris scores of the observation group and the control group were （87.3±10.4）,（77.2 ± 8.7）,which were higher than before treatment,while the observation group was higher than that of the control group,there was significant difference （P 〈 0.05）.The operation time,the amount of bleeding and the length of stay in the observation group were higher than those in the control group,there was significant difference （P 〈 0.05）.The incidence of postoperative complications and reoperation rate in the observation group were 4.44% （2/45） and 2.22% （1/45）,respectively,which were lower than those of the control group with 22.22% （10/45） and 15.56% （7/45）,there were significant differences （P 〈 0.05）. Conclusion Fracture fixation is less traumatic in elderly patients with femoral neck fracture.h is beneficial for promoting the early rehabilitation of the patient,and the clinical effect of the hip replacement is more remarkable,which can effectively promote the recovery of the hip joint function of the patients,and is more suitable for the elderly patients.