全髋关节置换术在老年髋部骨折患者中的应用效果

Application effect of total hip arthroplasty in elderly patients with hip fracture

目的分析全髋关节置换术(THA)在老年髋部骨折患者中的应用效果。方法选取2017年1月至2019年4月来我院骨科接受治疗的150例髋部骨折患者为研究对象,根据随机抽样法将患者分为Gamma钉固定组和THA组,每组75例。比较两组患者手术相关指标、生活质量、髋关节功能、并发症发生情况。结果THA组的术中出血量、住院费用、愈合时间、术后引流量、术后下床负重时间均优于Gamma钉固定组,但手术时间长于Gamma钉固定组(P<0.05);两组的住院时间、术后首次进流食时间无显著差异(P>0.05)。术后6、12个月,THA组的KPS和Harris量表评分高于Gamma钉固定组,Harris量表评分差的患者占比低于Gamma钉固定组(P<0.05)。两组术后并发症总发生率无显著差异(P=0.384)。结论THA和Gamma钉固定术均安全有效,THA可显著改善老年髋部骨折患者的术中出血量、愈合时间、住院费用等,有助于患者髋部功能早日恢复,虽手术时间较长,但整体效果优于Gamma钉固定术,临床可根据患者的自身条件选择手术方案。

Objective To analyze the application effect of total hip arthroplasty(THA)in elderly patients with hip fracture.Methods A total of 150 patients with hip fracture who received treatment in the orthopedics department of our hospital from January 2017 to April 2019 were selected as the research objects.According to the random sampling method,the patients were divided into Gamma nail fixation group and THA group,with 75 cases in each group.The operation related indexes,quality of life,hip joint function and complications were compared between the two groups.Results The intraoperative blood loss volume,hospitalization expenses,healing time,postoperative drainage volume,postoperative loading time out of bed of the THA group were better than those of the Gamma nail fixation group,but the operation time was longer than that of the Gamma nail fixation group(P<0.05);there were no significant differences in hospitalization time and the time of first intake of liquid food after operation between the two groups(P>0.05).At 6 and12 months after operation,the KPS and Harris scale scores of the THA group were higher than those of the Gamma nail fixation group,and the proportions of patients with poor Harris score were lower than those of the Gamma nail fixation group(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P=0.384).Conclusion THA and Gamma nail fixation are both safe and effective.THA can significantly improve the intraoperative blood loss volume,healing time and hospitalization expenses of elderly patients with hip fracture,and is help to the recovery of hip function of patients as soon as possible.Although the operation time is longer,the overall effect is better than Gamma nail fixation.The clinical can choose the operation plan according to the patients’own conditions.