骨折内固定术与髋关节置换术在老年股骨颈骨折中的应用效果

Application effect of internal fracture fixation and hip replacement in elderly femoral neck fractures

目的探讨骨折内固定术与髋关节置换术在老年股骨颈骨折中的应用效果。方法选取2020年4月至2021年12月北京市朝阳区双桥医院收治的80例股骨颈骨折病患作为研究对象,采用随机数字表法将其分为对照组和观察组,每组各40例。对照组患者采用骨折内固定术治疗,观察组患者采用髋关节置换术治疗。比较两组患者的治疗效果、手术相关指标(手术时间、术中失血量、术后卧床时间、术后住院时间)、躯体方面、心理方面、社会方面、总体感觉方面的生活质量和术后出现下肢肌肉疼痛、泌尿系感染、术后深静脉血栓的并发症总发生率。结果观察组患者的治疗有效率高于对照组,差异有统计学意义(P<0.05)。观察组患者术后出现下肢肌肉疼痛、泌尿系感染、术后深静脉血栓的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。观察组患者的术后卧床时间及术后住院时间短于对照组,手术时间长于对照组,术中失血量多于对照组,差异有统计学意义(P<0.05)。观察组患者术后躯体方面、心理方面、社会方面、总体感觉方面的生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论在老年股骨颈骨折病患的治疗中,采用髋关节置换术治疗比骨折内固定术治疗的效果显著,有利于提高治疗有效率,缩短患者术后卧床时间及术后住院时间,提高生活质量,减少术后并发症的发生。

Objective To investigate the application effect of internal fracture fixation and hip replacement in elderly femoral neck fractures.Methods A total of 80 patients with femoral neck fracture admitted to Shuangqiao Hospital,Chaoyang District,Beijing from April 2020 to December 2021 were selected as the study subjects.They were divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with internal fixation,and the observation group was treated with hip replacement.The therapeutic effect,surgery related indicators(operation time,intraoperative blood loss,postoperative bed time,postoperative hospitalization time),physical,psychological,social,the overall feel of quality of life and postoperative lower limb muscle pain,urinary tract infection,the total incidence of complications of postoperative deep vein thrombosis of two groups were compared.Results The effective rate of observation group was higher than that of the control group,the difference was statistically significant(P<0.05).The total incidence of postoperative complications of lower limb muscle pain,urinary tract infection and postoperative deep vein thrombosis in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The postoperative bed time and postoperative hospitalization time of patients in the observation group were shorter than those in the control group,the operation time was longer than that in the control group,and the intraoperative blood loss was more than that in the control group,the differences were statistically significant(P<0.05).The scores of physical,psychological,social and overall sensory quality of life in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion In the treatment of elderly patients with femoral neck fracture,hip replacement is more effective than fracture internal fixation,which is beneficial to improve the treatment efficiency,shorten the postoperative bed rest time and postoperative hospitalization time,and improve the quality of life,reduce the incidence of postoperative complications.