全髋与半髋关节置换治疗老年股骨颈骨折的临床效果比较

The clinical efficacy of total hip arthroplasty and hemiarthroplasty in elderly patients with femoral neck fracture

目的探讨全髋与半髋关节置换手术治疗老年股骨颈骨折的临床效果。方法选取该院骨科于2011-01~2014-01收治的78例老年股骨颈骨折患者,按随机数字表法将其分成对照组和观察组,每组39例,对照组行半髋关节置换手术治疗,观察组接受全髋关节置换手术治疗。观察并对比两组治疗效果。结果观察组优26例,良7例,可4例,差2例。对照组优16例,良9例,可8例,差6例。观察组的疗效显著优于对照组(P<0.05),但对照组住院时间、手术时间和术中出血量少于观察组(P<0.01);两组患者的切口感染率、假体翻修率以及并发症发生率比较差异无统计学意义(P>0.05)。结论全髋关节置换手术治疗老年股骨颈骨折,临床疗效显著,安全系数高,而半髋关节置换手术也具有术中出血量少、手术时间短等优点。因此,临床医师在治疗时应根据实际情况选择合适的手术方式。

Objective To discuss the clinical efficacy of total hip arthroplasty and hemiarthroplasty in elderly patients with femoral neck fracture.Methods 78 elderly patients with femoral neck fracture were selected in our hospital from January 2011 to January 2014, and were randomly divided into two groups, with 39 cases in each group. The control group received hemiarthroplasty, and the observation group received total hip arthroplasty. The clinical efficacy was observed and compared between the two groups.Results In the observation group, the clinical effect was markedly excellent in 26 cases, good in 7 cases, effective in 4 cases, and ineffective in 2 cases. In the control group, the clinical effect was markedly excellent in 16 cases, good in 9 cases, effective in 8 cases, and ineffective in 6 cases. The excellent rate of the observation group was significantly higher than that of the control group（P〈0.05）. The hospital stay, operation time and blood loss in the control group improved better than those in the observation group（P〈0.01）. There were no significant differences in the incisional infection rate, prosthesis revision rate and complication rate between the two groups（P〉0.05）.Conclusion Total hip arthroplasty is safe and effective for the elderly patients with femoral neck fracture, while hemiarthroplasty also has the advantages of less intraoperative bleeding and shorter operative time. Therefore, the clinicians should choose the appropriate surgical approaches for the patients individually.