双极人工股骨头置换术对高龄股骨颈移位骨折患者的影响

Influence of Bipolar Artificial Femoral Head Replacement on Elderly Patients with Displaced Femoral Neck Fracture

目的:研究双极人工股骨头置换术对高龄股骨颈移位骨折患者的疗效。方法:将兴山县人民医院2019年9月-2020年10月行手术治疗的87例股骨颈移位骨折患者,按照手术方式的不同,分为观察组(n=45,行双极人工股骨头置换术)与对照组(n=42,行人工全髋关节置换术),比较两组手术指标(手术时间、术中出血量、术后下床时间、住院时间),比较两组术前及术后3 d、术后1个月的疼痛情况[视觉模拟评分法(VAS)评分],比较两组术前及术后3、6、12个月的髋关节功能(Harris髋关节评分)、日常生活能力(Barthel指数),比较两组术后并发症发生情况。结果:观察组手术时间、术中出血量、术后下床时间、住院时间均显著优于对照组,差异有统计学意义(P<0.05)。两组术后3 d、1个月VAS评分均较术前显著降低,差异有统计学意义(P<0.05)。两组术后3、6、12个月Harris髋关节评分、Barthel指数均较术前显著提升,差异有统计学意义(P<0.05),组间比较,差异无统计学意义(P>0.05)。术后3 d观察组VAS评分显著低于对照组(P<0.05),术后1个月时两组VAS评分比较,差异无统计学意义(P>0.05)。观察组并发症总发生率低于对照组,但差异无统计学意义(P>0.05)。结论:双极人工股骨头置换术在高龄股骨颈移位骨折中治疗效果较好,能提升其Harris髋关节评分,手术创伤较小。

Objective:To study the effect of bipolar artificial femoral head replacement on elderly patients with displaced femoral neck fracture.Method:A total of 87 patients with displaced femoral neck fracture who underwent surgery in Xingshan People’s Hospital from September 2019 to October 2020 were divided into observation group(n=45,bipolar artificial femoral head replacement)and control group(n=42,total hip replacement).The perioperative indexes(operation time,intraoperative bleeding,postoperative bed time and hospital stay)of the two groups were compared,the pain[visual analogue scale(VAS)score]before,3 days and 1 month after operation were compared between the two groups,and the hip function(Harris hip score)and ability of daily living(Barthel index)before and 3,6,12 months after operation were compared,the incidence of postoperative complications was compared between the two groups.Result:The operation time,intraoperative bleeding,postoperative out of bed time and hospital stay in the observation group were significantly better than those in the control group,the differences were statistically significant(P<0.05).The VAS scores of the two groups at 3 days and 1 month after operation were significantly lower than those before operation,the differences were statistically significant(P<0.05).The Harris hip score and Barthel index of the two groups at 3,6 and 12 months after operation were significantly higher than those before operation,the differences were statistically significant(P<0.05),there were no significant differences between the two groups(P>0.05).The VAS score of the observation group was significantly lower than that of the control group at 3 days after operation(P<0.05).There was no significant difference between the two groups at 1 month after operation(P>0.05).The total complication rate in the observation group was lower than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion:Bipolar artificial femoral head replacement is effective in the treatment of displaced femoral neck fractures in the elderly,can improve the Harris hip score,and has less surgical trauma.