全髋关节置换术及半髋关节置换术治疗老年患者股骨颈骨折的临床疗效分析

Comparative Study on Clinical Efficacy between Total Hip Arthroplasty and Hemiarthroplasty in Treatment of Elderly Patients with Femoral Neck Fracture

目的对比分析全髋及半髋关节置换术治疗老年患者股骨颈骨折的疗效及安全性。方法回顾性分析本院收治的150例老年骨折患者的临床资料,所有患者均行手术治疗,其中88例采用全髋关节置换术(全髋组),62例采用半髋关节置换术(半髋组),比较两组患者的手术疗效及相关并发症的发生情况。结果 (1)全髋组患者手术时长、拔管时间、手术出血量及术后引流量均高于半髋组,差异具有显著性(P<0.05);(2)半髋组患者术后髋部疼痛发生率较全髋组明显增高,差异具有显著性(P<0.05),同时半髋组并发症的总发生率亦高于全髋组,但差异不具有显著性(P>0.05);(3)术后影像学提示:全髋组髋臼完好率显明显高于半髋组(P<0.05),而髋臼磨损的发生情况明显低于半髋组(P<0.05),髋臼增生、假体松动的发生情况在两组间差异不显著(P>0.05);(4)在半髋组,治疗的优良率为82.3%,在全髋组中,治疗的优良率为93.2%。全髋组治疗的优良率明显高于半髋组,差异具有显著性(P<0.05)。结论两种术式短期疗效均显著,在身体条件允许时,应用全髋关节置换进行手术临床疗效更好,远期效果更佳。

Objective To analyze the surgical effect between total hip arthroplasty(THA)and hemiarthroplasty in the treatment of patients with femoral neck fracture.Methods Clinical data of 150 elderly patients were analyzed retrospectively,all patients were treated with surgery,88 cases of them were performed with THA(THA group),and 62 cases were performed with hemiarthroplasty(hemiarthroplasty group).The postoperative complications and surgical effect were compared and analyzed.Results(1)The operating time,extubation time,intraoperative bleeding volume and drainage volume in the THA group were higher than those in the hemiarthroplasty group(P<0.05).(2)The incidence of hip pain in the hemiarthroplasty group was significant higher than that of the THA group(P<0.05),and the incidence rate of total complications was higher in the hemiarthroplasty group,but the difference was not significant(P>0.05);(3)Postoperative imaging indicated:The rate of in THA group was significantly higher than in Hemiarthroplasty group(P<0.05),while the incidence of acetabular wear in the THA group was significantly lower than that in the hemiarthroplasty group(P<0.05),but the difference between groups were not significant(P>0.05).(4)The clinical fine rate in the hemiarthroplasty group was 82.3%,and it was significant lower than that in the the group(P<0.05).Conclusion The THA and hemiarthroplasty were all effective surgical treatment,if the patients' physical conditions permitted,the surgical effect in the THA group is better than that in the hemiarthroplasty group,especially the long-term effect.