全髋关节置换术和双极半髋关节置换术治疗老年股骨颈骨折的临床效果比较

Comparison of Clinical Effects of Total Hip Arthroplasty and Bipolar Hemiarthroplasty in the Treatment of Femoral Neck Fractures in the Elderly

目的比较全髋关节置换术和双极半髋关节置换术治疗老年人股骨颈骨折的临床效果。方法选取2017年1月-2018年1月在沈阳中置盛京老年病医院进行手术治疗的90例老年股骨颈骨折患者,按照不同的手术方法分为观察组和对照组各45例。观察组采用全髋关节置换术治疗,对照组45例采用双极半髋关节置换术治疗。观察并比较两组的手术情况、围术期并发症以及术后不同时间点髋关节功能和生存质量。结果观察组手术时间和住院时间长于对照组,术中出血量大干对照组,差异均具有统计学意义(P<0.05)。两组术后并发症发生情况差异无统计学意义(P>0.05)。两组术后3个月髋关节功能Harris评分和生存质量简明健康调查问卷量表评分差异均无统计学意义(P>0.05)。术后6个月、12个月、24个月,观察组髋关节功能Harris评分和生存质量简明健康调查问卷量表评分均高于对照组,差异均具有统计学意义(P<0.05)。结论老年股骨颈骨折患者采用全髋关节置换术和双极半髋关节置换术治疗均可获得较好的近期效果,而且全髋关节置换术的远期效果优干双极半髋关节置换术。

Objective To compare the clinical ctTccts of total hip arthroplasty(THA)and bipolar hemiarthroplasty(BHA)in the treatment of femoral neck fracture(FNF)in the elderly.Methods A total of 90 elderly patients with FNF who underwent surgical treatment in Shenyang Zhongzhi Shengjing Geriatrics Hospital from January 2017 to January 2018 were selected.The patients were divided into the observation group and control group with 45 patients in each group according to different surgical methods.The observation group were treated with THA operation and the control group were treated with BHA operation.The surgical conditions,perioperative complications,hip joint function and quality of life at different time points after surgery between the two groups were observed and compared.Results The operation time and hospital stay of the observation group were significantly longer than those of the control group,and the blood loss during operation was significantly more than that of the control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).There was no significant difference in the Harris score of hip joint function and the simple health questionnaire scores of the quality of life between the two groups at 3 months after operation(P>0.05).At 6 months,12 months,and 24 months after surgery,the Harris scores of hip joint function and the simple health questionnaire scores of the quality of life of the observation group were significantly higher than those of the control group(P<0.05).Conclusion Elderly patients with FNF can obtain better short-tenn effects with THA and BHA,and the long-term effect of THA is better than that of BHA.