全髋关节置换术和双极人工股骨头置换术治疗老年股骨颈骨折疗效探究

Effect of Total Hip Arthroplasty and Bipolar Artificial Femoral Head Replacement on Femoral Neck Fractures in the Elderly

目的探讨全髋关节置换术和双极人工股骨头置换术治疗老年股骨颈折的效果。方法选择2017年8月—2019年5月该院收治的76例老年股骨颈骨折患者进行该次研究,严格按照随机数表法将其分为观察组和对照组,每组38例,观察组应用双极人工股骨头置换术进行治疗,对照组应用全髋关节置换术进行治疗,对比两组的围术期指标、髋关节功能评分及术后并发症发生的情况。结果观察组的手术时间为(78.52±5.67)min,对照组的手术时间为(96.01±5.74)min,对比差异有统计学意义(t=5.080,P<0.05);观察组的术中出血量为(310.20±21.54)mL,对照组的术中出血量为(340.27±22.28)mL,差异有统计学意义(t=2.250,P<0.05);观察组的住院时间为(20.38±1.74)d,明显短于对照组(24.63±1.69)d,差异有统计学意义(t=4.190,P<0.05)。治疗前,两组的Harris髋关节功能评分差异无统计学意义(P>0.05),治疗后,观察组的Harris髋关节功能评分显著高于对照组(P<0.05);对照组的术后并发症发生率为18.42%,高于观察组(2.63%)(χ2=5.030,P<0.05)。结论老年股骨颈骨折患者采用全髋节置换术和双极人工股骨头置换术,治疗效果十分理想,前者能够更有效改善髋关节功能,其远期效果好;后者创伤小,术中能够有效降低出血量,术后恢复较快。两种方法有利有弊,可根据患者自身的骨折情况选择合适的治疗方法。

Objective To investigate the effect of total hip arthroplasty and bipolar artificial femoral head replacement on the femoral neck fracture.Methods A total of 76 elderly patients with femoral neck fractures treated in the hospital from August 2017 to May 2019 were selected for this study.They were divided into observation group and control group strictly according to the random number table method,with 38 cases in each group.The observation group was treated with bipolar artificial femoral head replacement,and the control group was treated with total hip replacement.The perioperative indicators,hip function scores,and postoperative complications were compared between the two groups.Results The operation time in the observation group was(78.52±5.67)min,and the operation time in the control group was(96.01±5.74) min.The comparison difference was statistically significant(t=5.08,P<0.05).The intraoperative blood loss in the observation group It was(310.20±21.54)mL,and the intraoperative blood loss in the control group was(340.27±22.28)mL,the difference was statistically significant(t=2.250,P<0.05);the hospital stay in the observation group was(20.38±1.74) d,significantly shorter than the control group(24.63±1.69) d,the difference was statistically significant(t=4.190,P<0.05).Before treatment,there was no significant difference in Harris hip function score between the two groups(P>0.05).After treatment,the Harris hip function score of the observation group was significantly higher than that of the control group(P<0.05);the incidence of disease was 18.42%,which was higher than that in the observation group(2.63%)(χ2=5.030,P<0.05).Conclusion Total hip joint replacement and bipolar artificial femoral head replacement in elderly patients with femoral neck fractures are very effective.The former can effectively improve hip joint function and its long-term effect is good;the latter has less trauma and can be used during surgery.Effectively reduce the amount of bleeding and recover faster after surgery-There are pros and cons to both methods,and you can choose the appropriate treatment based on the patient’s own fracture.