老年患者髋关节置换术的治疗效果

Clinical efficacy of elderly hip arthroplasty

目的观察老年患者髋关节置换术的近期临床疗效。方法回顾性分析2014年1月至2017年1月首次行关节置换术的54例股骨头坏死和股骨颈骨折老年患者的临床资料。结果 54例患者中,获得随访50例,随访率为92.6%(50/54),随访时间(18.0±11.6)个月。患者末次随访Harris评分(86.3±5.6)分,高于术前(34.3±16.9)分(t=29.86,P> 0.01),优良率为84.0%,较术前提高(χ2=72.4,P>0.01);手术时间(97.3±42.9) min,术中出血量(382.1±257.1) ml,下地和住院时间(7.1±9.1)、(15.1±6.4) d,住院总费用(8 2029.9±3 3452.6)元;均未见严重并发症;对疗效满意度为(89.1±6.8)分。结论老年患者髋关节置换术的近期临床疗效满意,但应严格掌握适应证,选择合适的手术类型。

Objective To observe short-term clinical efficacy of hip arthroplasty for elderly femoral head osteonecrosis and neck fracture.Methods Fifty-four patients who underwent hip arthroplasty for the first time from January 2014 to January 2017 were analyzed retrospectively.Results Fifty cases had complete follow-up data,with a follow-up rate of 92.6%(50/54).The follow-up time was(18.0±11.6)months.The final follow-up Harris score(86.3±5.6) was significantly higher than that(34.3±16.9)before the operation(t=29.86,P>0.01),and the rate of good and excellent grades(84.0%) was significantly higher than that before operation(χ^2=72.4,P>0.01).The mean time of operation was(97.3±42.9) minutes,amount of intraoperative bleeding was(382.1±257.1) ml,time of leaving a sickbed and hospital stay were(7.1±9.1) and(15.1±6.4) respectively,total cost of hospitalization was(82029.9±33452.6) yuan.No patient had severe complications.The average satisfaction score for clinical efficacy was(89.1±6.8).Conclusions The clinical efficacy of arthroplasty on elderly femoral head osteonecrosis and neck fracture is satisfactory.However,the indications for hip arthroplasty should be strictly abided by and the choice of surgery types should be appropriate.