不同髋关节置换术治疗股骨颈骨折的临床效果对比

Comparison of Clinical Effects of Different Hip Replacement in the Treatment of Femoral Neck Fracture

目的:对比不同髋关节置换术治疗股骨颈骨折的临床效果。方法:回顾性分析,收集2020年3月-2021年10月赣南医学院第三附属医院及赣南医学院第一附属医院60例行髋关节置换术的股骨颈骨折患者的临床资料,依据手术方法的不同,将其中34例实施人工全髋关节置换术的患者纳入A组,26例实施双极人工股骨头置换术的患者纳入B组,两组均术后随访6个月。比较两组围手术期指标(手术时间、术中出血量、住院时间);术前及术后3、6个月,比较两组髋关节功能[Harris髋关节评分(HHS)];术前、术后6个月,比较两组生活自理能力[改良Barthel指数(MBI)];统计两组随访期间术后并发症发生情况。结果:与A组比较,B组手术时间更短,术中出血量更少(P<0.05);术后3、6个月,A组HHS评分均高于B组(P<0.05);术后6个月,与B组比较,A组MBI更高(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:与双极人工股骨头置换术相比,人工全髋关节置换术治疗股骨颈骨折虽然手术时间更长、术中出血量更多,但其安全性与前者相当,且更利于患者髋关节功能恢复和生活自理能力改善。

Objective: To compare the clinical effects of different hip replacements in the treatment of femoral neck fracture. Method: The clinical data of 60 patients with femoral neck fracture underwent hip replacement in the Third Affiliated Hospital of Gannan Medical College and the First Affiliated Hospital of Gannan Medical College from March 2020 to October 2021 were collected and retrospectively analyzed. According to the different surgical methods, 34 patients who underwent total hip replacement were included in group A, and 26patients who underwent bipolar artificial femoral head replacement were included in group B. Both groups were followed up for 6 months after surgery. Perioperative indicators(operation time, intraoperative bleeding volume,and hospital stay) were compared between the two groups. The hip joint function [Harris hip score(HHS)] was compared between the two groups before surgery, 3 and 6 months after surgery. The life self-care ability [modified Barthel index(MBI)] was compared between the two groups before and six months after surgery. The incidence of postoperative complications during the follow-up period was counted between the two groups. Result: Compared with the group A, the group B had a shorter operation time and less intraoperative bleeding volume(P<0.05). 3 and 6 months after surgery, HHS scores in the group A were higher than those in the group B(P<0.05). 6 months after surgery, compared with group B, MBI in group A was higher(P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion: Compared with bipolar artificial femoral head replacement, total hip replacement for femoral neck fracture takes longer operation time and more intraoperative bleeding volume. However, its safety is equal to that of the former, and it is more conducive to the recovery of hip joint function and the improvement of life self-care ability of patients.