直接前入路治疗高龄股骨颈骨折的效果分析

Effect of Artificial Femoral Head Replacement with Direct Anterior Approach in the Treatment of Femoral Neck Fracture in the Elderly

目的:探究直接前入路(DAA)治疗高龄股骨颈骨折的效果。方法:选取2017年1月-2020年12月莆田市第一医院高龄股骨颈骨折患者156例。参照随机数字表法将其分为参照组和研究组,各78例。两组均进行人工股骨头置换术,参照组采取后外侧入路(PLA),研究组采取DAA。对比两组围手术期指标,术后3、6周,3、6个月的髋关节功能,下肢深静脉血栓(DVT)发生率。结果:研究组切口长度、住院时间均短于参照组,术中出血量少于参照组,下床行走时间早于参照组(P<0.05)。研究组术后3、6周,3、6个月的Harris评分均高于参照组(P<0.05)。参照组、研究组下肢DVT发生率分别为3.85%(3/78)、2.56%(2/78),两组DVT发生率相比差异无统计学意义(χ^(2)=0.207,P=0.649)。结论:DAA治疗高龄股骨颈骨折患者的效果明确,能够加快康复进程,且不会增加术后DVT发生,应用价值较高,推荐使用。

Objective:To explore the effect of artificial femoral head replacement with direct anterior approach(DAA)in the treatment of femoral neck fracture in the elderly.Method:A total of 156 elderly patients with femoral neck fracture in Putian First Hospital from January 2017 to December 2020 were selected.According to random number table method,they were divided into the reference group and the study group,78 cases in each group.Artificial femoral head replacement was performed in both groups,posterolateral approach(PLA)was used in the reference group and DAA was used in the study group.The perioperative indexes,hip joint function at 3,6 weeks and 3,6 months after surgery and the incidence of deep venous thrombosis(DVT)of lower extremity were compared between the two groups.Result:The incision length and hospital stay of the study group were shorter than those of the reference group,the amount of intraoperative blood loss was less than that of the reference group,and the ambulation time out of bed in the study group was earlier than that in the reference group(P<0.05).The Harris scores of the study group were higher than those of the reference group at 3,6 weeks and 3,6 months after surgery(P<0.05).The incidence of DVT of lower extremity in the reference group and study group were 3.85%(3/78),2.56%(2/78)respectively,and there was no significant difference in the incidence of DVT of lower extremity between the two groups(χ^(2)=0.207,P=0.649).Conclusion:DAA has a clear effect on the treatment of elderly patients with femoral neck fracture,can accelerate the rehabilitation process,and does not increase the incidence of postoperative DVT.Therefore,it has high application value and is recommended to be used.