全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的临床探究

Clinical Study of Total Hip Arthroplasty and Hemiarthroplasty for the Treatment of Femoral Neck Fracture in the Elderly

目的探讨全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的临床效果。方法方便选择2015年9月—2017年2月在该院接受置换术治疗的80例老年股骨颈骨折患者,为对照组与观察组各40例,对照组采用半髋关节置换术治疗,观察组行全髋关节置换术治疗,比较两组患者临床治疗效果。结果观察组患者手术时间为(126.3±17.7)min、术中出血量为(352.4±30.9)mL,与对照组(90.4±13.1)min、(240.8±41.3)mL比较,差异有统计学意义(t=4.124、5.257,P<0.05);观察组患者髋关节功能恢复时间为(10.6±1.3)d、术后VAS评分为(5.7±0.8)分,与对照组(9.6±3.4)d、(6.0±0.7)分相比较,差异无统计学意义(t=0.145、1.203,P>0.05)。观察组患者术后并发症发生率为5.0%,显著低于对照组17.5%,组间差异有统计学意义(χ~2=4.210,P<0.05)。观察组患者术后优良率为92.5%,显著高于对照组70.0%,组间差异有统计学意义(χ~2=6.646,P=0.001<0.05)。结论全髋关节置换术治疗老年股骨颈骨折术后并发症相对较少,术后功能优良率较高,在对老年股骨颈骨折患者临床治疗中具有一定推广价值。

Objective To investigate the clinical effects of total hip arthroplasty and hemiarthroplasty in the treatment of femoral neck fractures in the elderly. Methods Convenient select eighty patients with femoral neck fractures who underwent replacement surgetT in the hospital from September 2015 to February 2017 were enrolled. The patients in the control group and the observation group were treated with hemi-hip arthroplasty. Total hip arthroplasty was used to compare the clinical effects of the two groups. Results The operation time of the observation group was （126.3±17.7）lnin, the intraoperative blood loss was （352.4±30.9）mL,compared with the control group （90.4±13.1）min, （240.8±41.3）mL, and the difference was signifi- cant （t= 4.24, 5.257, P〈0.05）; the recovery time of hip function in the observation group was （10.6±1.3）days, the postopera- tive VAS score was （5.7±0.8）points, and the control group （9.6±3.4）d, （6.0± 0.7）points, the difference was not significant （t= 0.145, 1.203, P〉0.05）. The postoperative complication rate was 5.0% in the observation group, which was significantly lower than that in the control group （17.5%）. The difference between the two groups was statistically significant （χ^2=4.210, P〈 0.05）. The excellent and good rate of postoperative patients was 92.5%, which was significantly higher than that of the con- trol group （70.0%）. The difference between the two groups was statistically significant（χ^2=6.646, P=0.001 〈0.05）. Conclusion Total hip arthroplasty has relatively few postoperative complications in the treatment of femoral neck fractures in the elderly. The postoperative functional excellence rate is high. It has certain promotion value in the clinical treatment of elderly pa- tients with femoral neck fracture.