髋关节置换术改善老年股骨颈骨折患者髋关节功能及炎性应激的效果研究

The Effect of Hip Arthroplasty on Hip Joint Function and Inflammatory Stress in Elderly Patients with Femoral Neck Fracture

目的:研究分析人工股骨头置换术和全髋关节置换术治疗老年股骨颈骨折患者的临床效果,为老年股骨颈骨折的临床治疗实践提供依据。方法:选取2016年7月-2018年7月笔者所在医院骨科收治的88例老年股骨颈骨折患者,根据患者手术方式将其分成研究组和对照组,各44例。研究组给予全髋关节置换术治疗,对照组给予人工股骨头置换术治疗。对比分析两组患者术中出血量、手术时间、下床活动时间、住院天数、髋关节功能评价结果及炎性因子指标水平。结果:对照组患者的手术时间、术中出血量、术后引流量和住院时间等手术临床指标均低于研究组,组间比较差异均有统计学意义(P<0.05)。对照组患者术后1年髋关节功能评分的优良率为72.72%,显著低于研究组的95.45%,组间比较差异有统计学意义(P<0.05)。对照组患者的IL-1、TNF-α、5-HT和PGE2等炎性因子指标均明显高于研究组,组间比较差异均有统计学意义(P<0.05)。结论:全髋关节置换术治疗老年股骨颈骨折患者的临床远期效果较好,患者术后髋关节功能恢复良好,炎症反应可以得到有效控制,有利于改善患者术后生活质量。

Objective:To analyze the clinical effects of artificial femoral head replacement and total hip arthroplasty in the treatment of femoral neck fractures in the elderly patients,and to provide evidence for clinical treatment of femoral neck fractures in the elderly.Method:A total of 88 elderly patients with femoral neck fractures admitted to the department of orthopaedics of the hospital from July 2016 to July 2018 were chosen.The patients were divided into the study group and the control group according to the surgical procedure,and 44 cases in each group.The study group was received total hip arthroplasty and the control group was received artificial femoral head replacement.The intraoperative blood loss,operation time,time to get out of bed,hospitalization days,hip function evaluation results and inflammatory factor index levels were compared between the two groups.Result:The clinical indexes of the operation time,intraoperative blood loss,postoperative drainage volume and hospitalization time were lower in the control group than in the study group,the differences between the two groups were with statistical significance(P<0.05).The excellent and good rate of hip function score was 72.72%in the observation group 1 year after surgery,which was significantly lower than 95.45%in the study group,the differences between the two groups were with statistical significance(P<0.05).The inflammatory factors of IL-1,TNF-α,5-HT and PGE2 in the control group were significantly higher than those in the study group,and the differences between the groups were with statistical significance(P<0.05).Conclusion:Total hip arthroplasty is effective in the treatment of elderly patients with femoral neck fracture.The postoperative hip function is well recovered,and the inflammatory response can be effectively controlled,which is beneficial to improve the postoperative quality of life.