全髋关节置换术与半髋关节置换术治疗老年股骨颈骨折的效果比较研究

Comparative effectiveness research of total hip replacement arthroplasty and hemiarthroplasty in the treatment of elderly femoral neck fracture

目的比较全髋关节置换术与半髋关节置换术治疗老年股骨颈骨折的临床效果。方法选取峨眉山市中医院2013年1月—2015年8月收治的老年股骨颈骨折患者88例,按照双盲法分为全髋置换组与半髋置换组,每组44例。全髋置换组患者行全髋关节置换术,半髋置换组患者行半髋关节置换术。比较两组患者术后恢复情况、手术相关指标(拔管时间、术中出血量、手术时间、引流量、负重时间、住院时间)及术后并发症发生情况。结果半髋置换组患者术后恢复优良率低于全髋置换组(P<0.05)。半髋置换组患者拔管时间、手术时间短于全髋置换组,术中出血量、引流量少于全髋置换组,负重时间长于全髋置换组(P<0.05)。两组患者住院时间比较,差异无统计学意义(P>0.05)。半髋置换组患者术后并发症发生率高于全髋置换组(P<0.05)。结论与半髋关节置换术比较,全髋关节置换术治疗老年股骨颈骨折的临床效果更确切,可提高患者术后恢复效果,且并发症少。

Objective To compare the clinical effect of total hip replacement arthroplasty and hemiarthroplasty in the treatment of elderly femoral neck fracture.Methods A total of 88 cases of elderly patients with femoral neck fracture were selected from January 2013 to August 2015 in Mount Emei Hospital of Traditional Chinese Medicine,which were randomly divided into total hip replacement group and half a hip replacement group,44 cases in each group.The total hip replacement group was given total hip replacement arthroplasty,half a hip replacement group was given hemiarthroplasty.The postoperative recovery,related indicators（extubation time,intraoperative bleeding volume,operation time,volume of drainage,the load time,hospitalization time）and postoperative complications were compared between the two groups.Resultes The postoperative recovery rate in half a hip replacement group was lower than total hip replacement group（P〈0.05）.The half a hip replacement group of extubation time,operation time were shorter than total hip replacement group,intraoperative bleeding volume,volume of drainage were less than total hip replacement group,the load time was longer than total hip replacement group（P〈0.05）.No significant statistical difference of hospitalization time was found between the two groups（P〉0.05）.The incidence rate of complications in half a hip replacement group was higher than total hip replacement group（P〈0.05）.Conclusion Compared with hemiarthroplasty,total hip replacement arthroplasty has an exactly clinical effect in treating elderly femoral neck fracture,it can improve the postoperative recovery effect of patients,and with less complications.