全髋关节置换术治疗中老年创伤性股骨头缺血性坏死的效果及安全性

Efficacy and safety of total hip arthroplasty on middle-aged and elderly patients with traumatic avascular necrosis of femoral head

目的探讨全髋关节置换术治疗中老年创伤性股骨头缺血性坏死的效果及安全性。方法抽取2015年1月至2020年12月郑州市骨科医院收治的中老年(46~71岁)创伤性股骨头缺血性坏死患者96例,按照手术方式将其分为两组。置换组48例行全髋关节置换术,置骨组48例行粗通道髓芯减压打压植骨术。比较两组围术期指标、手术效果、髋关节功能(Harris评分)、疼痛程度及并发症。结果置换组住院时间、术中出血量少于置骨组(t=-13.180、-14.469,P<0.05)。治疗后1个月,置换组Harris评分高于置骨组、VAS评分低于置骨组(t=6.969、-19.319,P<0.05)。置换组治疗优良率为95.83%(46/48),高于置骨组的62.50%(30/48),χ2=7.957,P=0.005。置换组并发症发生率为4.17%(2/48),低于置骨组的12.50%(6/48),但χ2=2.182,P=0.140。结论全髋关节置换术治疗中老年创伤性股骨头缺血性坏死疗效较好,住院时间短,术中出血量少,可有效缓解疼痛,改善患者髋关节功能,且手术安全性较高。

Objective To investigate the efficacy and safety of total hip arthroplasty on middle-aged and elderly patients with traumatic avascular necrosis of femoral head.Methods A total of 96 middle-aged and elderly patients(46-71 years old)with traumatic avascular necrosis of the femoral head who were admitted to Zhengzhou Orthopedic Hospital from January 2015 to December 2020 were selected,and they were divided into two groups according to surgical methods.Forty-eight patients in the replacement group underwent total hip arthroplasty,and 48 patients in the bone placement group underwent thick channel core decompression suppressing bone graft.The perioperative indicators,surgical results,hip joint function(Harris score),pain degree and complications were compared between the two groups.Results The hospitalization time and intraoperative blood loss in the replacement group were less than those in the bone placement group(t=-13.180,-14.469,P<0.05).One month after treatment,the Harris score of the replacement group was higher than that in the bone placement group,and the VAS score was lower than that in the bone placement group(t=6.969,-19.319,P<0.05).The excellent and good rate of treatment in the replacement group was 95.83%(46/48),which was higher than 62.50%(30/48)in the bone placement group,χ2=7.957,P=0.005.The complication rate in the replacement group was 4.17%(2/48),which was lower than 12.50%(6/48)in the bone placement group,butχ2=2.182,P=0.140.Conclusions Total hip arthroplasty has a good effect on traumatic avascular necrosis of femoral head,which can shorten hospital stay,reduce intraoperative bleeding,effectively relieve the pain,improve the function of hip joint and with higher safety.