全髋关节置换与人工股骨头置换治疗高龄患者股骨颈骨折的临床效果对比

Total Hip Arthroplasty and Hemiarthroplasty Treatment of Elderly Patients with Femur Tibia Fracture Clinical Effect Comparative Study

目的:观察全髋关节置换与人工股骨头置换在高龄患者股骨颈骨折中的临床治疗效果。方法:选取2014年1月-2017年1月笔者所在医院诊治的高龄股骨颈骨折患者50例,根据治疗方案不同分为对照组(n=25)和观察组(n=25)。对照组采用全髋关节置换治疗,观察组采用人工股骨头置换治疗,比较两组临床疗效。结果:两组患者住院天数比较,差异无统计学意义(t=0.650 0,P>0.05);观察组手术时间短于对照组,术中出血量、术后引流量显著少于对照组,差异均有统计学意义(t=3.2794、16.3551、4.7053,P<0.05);两组术后3个月Harris评分比较,差异无统计学意义(t=0.264 1,P>0.05);观察组术后6、12个月Harris评分均显著低于对照组,差异均有统计学意义(t=3.584 8、2.266 0,P<0.05);观察组术后并发症发生率(36.4%)显著高于对照组(9.1%),差异有统计学意义(X^2=6.030 0,P<0.05)。结论:全髋关节置换与人工股骨头置换在高龄患者股骨颈骨折中各有其优势,人工股骨头置换具有手术时间短、功能关节恢复快等优点,而全髋关节置换具有远期疗效理想,术后并发症发生率低的优点,应加强术前评估,选择合适的手术方案。

Objective：To observe the total hip arthroplasty and hemiarthroplasty in elderly patients with femoral neck fracture in clinical effect.Method：From January 2014 to January 2017,50 elderly patients with femoral neck fracture treated in our hospital were selected and divided into control group（n=25） and observation group（n=25） according to the different treatment options.The control group treated with total hip replacement and the observation group treated with hemiarthroplasty,the clinical efficacy of two groups were compared.Result：The difference of hospitalized days between the two groups had no statistic significant（t=0.650 0,P〈0.05）.The operative time of observation group was shorter,the blood loss,postoperative drainage were less than those of the control group,the differences were statistically significant（t=3.279 4,16.355 1,4.705 3,P〈0.05）.There was no significant difference between the two groups after 3 months of Harris score（t=0.264 1,P〈0.05）.The Harris score in the observation group was significantly lower than those in the control group at 6 and 12 months after operation,the differences were statistically significant（t=3.584 8,2.266 0,P〈0.05）.The incidence of postoperative complications with 36.4% in the observation group was significantly higher than 9.1% in the control group,and the difference was statistically significant（X^2=6.030 0,P〈0.05）.Conclusion：Total hip arthroplasty and hemiarthroplasty in elderly patients with femoral neck fractures have their own advantages,hemiarthroplasty with a shorter operative time,quicker recovery of joint function,and total hip replacement with the desired long-term effect,the postoperative complication rate advantage,should strengthen the preoperative evaluation,select appropriate surgical plan.