改良SuperPATH入路股骨头置换联合氨甲环酸治疗高龄股骨颈骨折患者的近期疗效

Short-term efficacy of femoral head replacement by modified SuperPATH approach combined with tranexamic acid in treatment of elderly patients with femoral neck fracture

目的评价改良SuperPATH入路股骨头置换联合使用氨甲环酸治疗高龄股骨颈骨折患者的近期疗效。方法 28例高龄股骨颈骨折患者采取改良SuperPATH入路股骨头置换。其中,A组22例,围手术期使用氨甲环酸,B组6例,未使用氨甲环酸。比较两组围手术期Hb、血细胞比容(Hct)、术后引流量、负重时间以及髋关节Harris评分。结果两组术前Hb、Hct和Harris评分无统计学差异(P>0.05)。与B组相比,A组术后引流量减少,贫血发生率降低,术后开始负重时间早(P<0.05)。术后1周,A组髋关节Harris评分优于B组(P<0.05);但两组术前及术后3个月髋关节Harris评分比较无统计学差异(P>0.05)。结论改良SuperPATH入路股骨头置换联合使用氨甲环酸治疗高龄股骨颈骨折患者疗效满意,康复快。

Objective To evaluate the short-term efficacy of femoral head replacement by modified SuperPATH approach combined with tranexamic acid in the treatment of elderly patients with femoral neck fracture.Methods Twenty-eight elderly patients with femoral neck fracture accepted femoral head replacement by modified SuperPATH approach,who were divided into two groups of A(22 cases) and B(6 cases).The patients in group A were treated with tranexamic acid perioperatively and those in group B were not use of tranexamic acid.The levels of Hb and Hct,volume of drainage,time of weight loading and Harris score were compared between two groups.Results There were no statistical differences in the Hb,Hct and Harris score before operation between groups of A and B(P>0.05).Compared with group B,group A had less volume of postoperative drainage,lower incidence of anemia and earlier time of weight loading after operation(P<0.05).The Harris score in the 1st week after operation in group A was better than that in group B(P<0.05),which in groups of A and B in the 3rd month after operation were similar(P>0.05).Conclusion The efficacy of femoral head replacement by modified SuperPATH approach combined with tranexamic acid in the treatment of elderly patients with femoral neck fracture is satisfied with a quicker recovery after operation.