全髋关节置换术与半髋关节置换术治疗股骨颈骨折的疗效比较

Curative effects comparison of replacement of total hip and hemiarthroplasty in the treatment of femoral neck fracture

目的探讨全髋关节置换术与半髋关节置换术治疗股骨颈骨折的临床疗效。方法选择2012年2月至2017年2月在我院诊治的股骨颈骨折患者70例,根据随机信封抽签原则分观察组与对照组,各35例。所有患者在入院10 d内实施手术。观察组给予半髋关节置换术,对照组给予全髋关节置换术。比较两组的预后情况。结果所有患者均顺利完成手术。与对照组相比,观察组患者的置换时间、出血量、引流量及开始活动时间均明显更优(P<0.05)。术后1个月两组均无死亡发生,对照组的并发症总发生率为5.71%,观察组并发症总发生率为8.57%,对照组的并发症总发生率低于观察组,但组间差异不显著(P>0.05),经对症治疗后均明显好转。结论半髋关节置换术治疗股骨颈骨折具有创伤小、患者恢复快等优点,全髋关节置换术能减少术后并发症的发生,临床治疗中需根据患者的具体情况及患者的并发症情况选择合理的手术方式。

Objective To explore the clinical effect of replacement of total hip and hemiarthroplasty in the treatment of femoral neck fracture. Methods A total of 70 patients with femoral neck fractures in our hospital from February 2012 to February 2017 were selected and divided into observation group and control group with random envelope method, with 35 cases in each group. All patients underwent surgeries within 10 d after admission. The observation group received hemiarthroplasty, and the control group received replacement of total hip. The prognosis of the two groups was compared. Results All surgeries were successfully performed. Compared with the control group, the replacement time, the amount of bleeding,the amount of drainage and the start time in the observation group were significantly better（P〈0.05）. No death occurred in either group within 1 month after the surgery. The total incidences of complication rate of the control group was 5.71%, while the observation group was 8.57%, there was no statistical difference between the two groups（P〉0.05）, and they improved after symptomatic treatment. Conclusion Hemiarthroplasty on femoral neck fractures has the advantages of small trauma and rapid recovery, replacement of total hip can reduce the incidence of postoperative complications. In clinical treatment, a reasonable surgical method should be chosen according to the patients＇ specific conditions and the patients＇ complications.