人工双极股骨头置换术治疗老年移位型股骨颈骨折近期疗效分析以及术后康复方式探讨

Analysis of short-term efficacy and discussion on postoperative rehabilitation methods of artificial bipolar femoral head replacement in treatment of senile femoral neck fracture

目的探讨人工双极股骨头置换术(BFHR)治疗老年移位型股骨颈骨折的近期疗效以及术后康复方式。方法选取2017年8月~2018年12月我院收治的80例移位型股骨颈骨折患者作为研究对象,按照随机数字表法将其分为对照组(40例)与观察组(40例)。两组患者均行BFHR治疗,对照组患者采用行常规干预方法,观察组患者采用早期康复训练方法。比较两组患者的手术指标、髋关节功能、生活质量、并发症总发生率。结果两组患者的手术时间、术中出血量、术后引流、住院时间、下床行走时间比较,差异无统计学意义(P>0.05);观察组患者术后12个月的Harris评分高于对照组,差异有统计学意义(P<0.05);两组患者术后12个月的Harris评分均低于术后6个月,差异有统计学意义(P<0.05);观察组患者的生理功能、生理受限、躯体疼痛、情感角色、社会功能和总体健康评分高于对照组,差异均有统计学意义(P<0.05);观察组患者的术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论BFHR治疗老年移位型股骨颈骨折的近期恢复效果较好,且进行早期康复训练利于患者髋关节功能恢复,提高生活质量,且并发症发生率较低,值得临床应用推广。

Objective To investigate the short-term efficacy and its postoperative rehabilitation methods of artificial bipolar femoral head replacement(BFHR)in the treatment of senile femoral neck fracture.Methods A total of 80 patients with displaced femoral neck fracture who admitted in the hospital from August 2017 to December 2018 were selected as the research objects,and they were divided into control group(40 cases)and observation group(40 cases)according to the random number table method.Two groups were treated with BFHR,control group was given routine nursing,and observation group was given early rehabilitation training.The surgical indexes,hip joint function,quality of life,and the total incidence of complications were compared between two groups.Results There were no statistically significant differences between the two groups in operation time,intraoperative blood loss,postoperative drainage,length of hospital stay,and off-bed walking time(P>0.05).Twelve months after surgery,the Harris score in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Harris scores in both groups at 12 months after surgery were lower than those at 6 months after surgery,and the differences were statistically significant(P<0.05).The scores of physiological function,physiological limitation,physical pain,role emotional,social function and general health in observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion BFHR in treatment of senile displaced femoral neck fracture has better short-term recovery effect.Early rehabilitation training can promote recovery of hip joint function,improve quality of life and have lower incidence of complications.It is worth popularizing in clinical application.