前外侧入路下不同髋关节置换方式治疗老年股骨颈骨折的疗效比较

Comparison of Curative Effect Different Hip Replacement Methods in the Treatmentof Femoral Neck Fracture in the Elderly Through Anterolateral Approach

目的探究前外侧入路下不同髋关节置换方式治疗老年股骨颈骨折的临床效果。方法选取2018年1月~2019年12月我院收治的老年股骨颈骨折患者100例,根据前外侧入路下髋关节置换方式不同分为研究组与对照组,各50例。对照组予前外侧入路下半髋关节置换方式,研究组予前外侧入路下全髋关节置换方式,比较比较两组临床指标(手术时间、住院时间、出血量、切口长度)、骨代谢指标[骨特异性碱性磷酸酶(BAP)、骨该素(BGP)、Ⅰ型胶原羧基端肽(β-CTX)]、炎症因子指标[肿瘤坏死因子α(TNF-α)、白介素-1(IL-1)]。结果研究组手术时间、住院时间、出血量优于对照组,差异有统计学意义(P<0.05);研究组BAP、BGP水平高于对照组[(42.01±5.31)ng/ml vs(33.14±4.69)ng/ml]、[(9.59±1.21)ng/ml vs(8.75±0.92)ng/ml],β-CTX水平低于对照组[(201.89±38.32)pg/ml vs(310.77±40.06)pg/ml],差异有统计学意义(P<0.05);研究组TNF-α、IL-1水平低于对照组[(12.56±2.01)pg/ml vs(18.56±2.34)pg/ml]、[(3.01±0.29)pg/ml vs(4.21±0.54)pg/ml],差异有统计学意义(P<0.05)。结论在老年股骨颈骨折中采用前外侧入路下全髋关节置换方式虽手术时间较长,但治疗效果更佳,能有效促进骨代谢与再生,改善炎症,有利于患者恢复。

Objective To explore the clinical effect of different hip replacement methods under anterolateral approach in the treatment of femoral neck fracture in the elderly.Methods from January 2018 to December 2019,100 elderly patients with femoral neck fracture were selected and divided into study group and control group according to the different ways of hip replacement under anterolateral approach,50 cases in each group.The control group received anterolateral approach for lower hemi hip replacement,and the study group received anterolateral approach for total hip replacement.The clinical indicators(operating time,hospital stay,blood loss,incision length)and bone metabolism were compared between the two groups.Indexes[Bone-specific alkaline phosphatase(BAP),Bone(BGP),Type I collagen carboxy-terminal peptide(β-CTX)],inflammatory factor indexes[Tumor necrosis factorα(TNF-α),interleukin-1(IL-1)].Results The operation time,hospitalization time,blood loss of the study group were better than those of the control group,the difference was statistically significant(P<0.05);the BAP and BGP levels of the study group were higher than those of the control group[(42.01±5.31)ng/ml vs(33.14±4.69)ng/ml],[(9.59±1.21)ng/ml vs(8.75±0.92)ng/ml],the level ofβ-CTX was lower than that of the control group[(201.89±38.32)pg/ml vs(310.77±40.06)pg/ml],the difference was statistically significant(P<0.05);the levels of TNF-αand IL-1 in the study group were lower than those in the control group[(12.56±2.01)pg/ml vs(18.56±2.34)pg/ml],[(3.01±0.29)pg/ml vs(4.21±0.54)pg/ml],the difference was statistically significant(P<0.05).Conclusion The total hip replacement with anterolateral approach in the elderly patients with femoral neck fracture has a long operation time,but the treatment effect is better.It can effectively promote bone metabolism and regeneration,improve inflammation,and help patients recover.