髋关节前路微创全髋关节置换术与股骨头置换术治疗老年股骨颈骨折的临床疗效对比研究

Minimally invasive total hip arthroplasty versus femoral head replacement in treatment of elderly patients with femoral neck fracture

目的对髋关节前路微创全髋关节置换术与股骨头置换术治疗老年股骨颈骨折的临床疗效进行对比研究。方法将2018年1月至2020年1月因股骨颈骨折在本院住院的患者80例纳入为研究对象,采用数字随机法分为两组,各40例。对照组采用股骨头置换,观察组采用前路微创全髋关节置换术;比较两组患者手术相关指标和住院时间、术后并发症发生情况、术后不同时间置换后髋关节功能。结果观察组手术时间为(100.6±12.6)min,高于对照组(70.51±2.4)min,出血量为(124.5±34.5)ml,低于对照组(246.8±91.5)ml,差异均有统计学意义(均P<0.05);两组患者住院时间比较,差异无统计学意义(P>0.05);两组患者术后不良反应发生率比较,差异无统计学意义(P>0.05);两组患者术后2个月髋关节功能比较,差异无统计学意义(P>0.05);观察组术后1年治疗有效率为97.5%(39/40),高于对照组85.0%(34/40),差异有统计学意义(P<0.05)。结论股骨颈骨折患者采用髋关节前路微创全髋关节置换术与股骨头置换均可取得一定的疗效,而在短期内两种方法无明显差异,但是长期效果还是髋关节置换术好,在实践中可灵活应用。

Objective To explore the clinical effects of minimally invasive total hip arthroplasty versus femoral head replacement in the treatment of elderly patients with femoral neck fracture.Methods From January,2018 to January,2020,80 patients hospitalized at our hospital for femoral neck fracture were included as the research objects.The patients were divided into an observation group and a control group by using the digital random method,with 40 cases in each group.The control group was treated with femoral head replacement,and the observation group with anterior minimally invasive total hip arthroplasty.The operation related indicators,hospitalization times,occurrence of postoperative complications of the two groups,and hip function after replacement at different times were compared between the two groups.Results The operation time was longer but the bleeding volume was lower in the operation group than in the control group[(100.6±12.6)min vs.(70.51±2.4)min and(124.5±34.5)ml vs.(246.8±91.5)ml;both P<0.05]. There were no statistical differences in the hospital stay, incidence of postoperativeadverse reactions, and hip function 2 months after the operation between these two groups (all P>0.05). One year after the operation, the treatment effective rate was higher in the observation groupthan in the control group [97.5% (39/40) vs. 85.0% (34/40);P<0.05]. Conclusion Minimallyinvasive total hip arthroplasty and femoral head replacement for patients with femoral neck fractureboth can achieve a certain effect, with no statistical difference in the short term effect, but hipreplacement has a better long-term effect and can be flexibly applied in practice.