内固定手术与人工髋关节置换术治疗老年髋部骨折对疼痛及髋关节功能的影响

Effect of Internal Fixation and Artificial Hip Replacement on Pain and Hip Function in Elderly Patients with Hip Fracture

目的 对比人工髋关节置换术、内固定手术在治疗老年髋部骨折中的具体价值。方法 选取2021年2月至2022年5月本院收治的老年髋部骨折患者60例,根据治疗方式的不同分对照组(30例)行内固定手术,观察组(30例)行人工髋关节置换术。对两组手术效果加以分析。结果 对比两组住院时间、下地锻炼时间,观察组均短于对照组,P<0.05。对比两组术后疼痛程度以及髋关节功能评分,术前两组差异无统计学意义,P>0.05,观察组术后1、2、3个月疼痛程度以及髋关节功能均优于对照组,P<0.05。在术后恢复过程中,观察组3例出现并发症,1例脱位、1例感染、1例血栓,对照组7例出现并发症,2例畸形愈合、1例感染、3例血栓、1例神经损伤,对比P<0.05。在手术时间上,观察组为(85.34±2.12)min,对照组为(94.53±3.11)min,对比P<0.05。在术中出血量上,观察组为(422.22±11.21)mL,对照组为(332.65±10.02)mL,对比P<0.05。对比两组恢复期间生活质量,观察组各维度评分均高于对照组,P<0.05。结合在手术后首日对两组患者体内TNF-α水平、IL-6水平、IL-10水平以及CRP水平进行统计,差异无统计学意义,P>0.05。对比患者在手术后第5日,观察组患者体内TNF-α水平、IL-6水平、IL-10水平以及CRP水平均低于对照组,P<0.05。结论 老年髋部骨折患者进行人工髋关节置换术治疗与内固定手术相比更具优势,手术过程中对患者造成的创伤较小,术后并发症较少,患者术后恢复过程中疼痛程度较低,髋关节功能可以在较短时间内得到恢复,且可以有效保障患者在术后恢复过程中的生活质量,促使患者术后炎性反应症状迅速得到改善,有助于提升患者的综合手术效果。

Objective To compare the specific value of hip replacement and internal fixation in the treatment of hip fracture in the elderly.Methods Sixty elderly patients with hip fracture who were admitted to our hospital from February 2021 to May 2022 were divided into control group(30 cases) and observation group(30 cases) according to different treatment methods. The surgical effects of the two groups were analyzed.Results Compared with the two groups, the time of hospitalization and ground exercise in the observation group was shorter than that in the control group(P<0.05). The pain degree and hip joint function score of the two groups were compared, and there was no difference between the two groups before operation(P>0.05). The pain degree and hip joint function of the observation group at 1 month, 2 months and 3 months after operation were better than those of the control group, P<0.05. In the process of postoperative recovery, 3 cases in the observation group had complications, 1 case of dislocation, 1 case of infection, 1 case of thrombosis, 7 cases in the control group had complications, 2 cases of malunion, 1 case of infection, 3 cases of thrombosis, 1 case of nerve injury, P<0.05. In terms of operation time, the observation group was(85.34±2.12) min, and the control group was(94.53±3.11) min, P<0.05. In terms of intraoperative bleeding volume, the observation group was(422.22±11.21) ml, and the control group was(332.65±10.02) ml, P<0.05. By comparing the quality of life of the two groups during recovery,the scores of each dimension in the observation group were higher than those in the control group(P<0.05). There was no significant difference in the levels of TNF-α, IL-6, IL-10 and CRP between the two groups on the first day after operation(P>0.05). The levels of TNF-α, IL-6, IL-10and CRP in the observation group were lower than those in the control group on the 5th day after operation(P<0.05). Conclusion Artificial hip replacement in older patients with hip fractures has advantages over internal fixation surgery, the operation process causes less trauma to the patients, less postoperative complications, less pain in the process of postoperative recovery, and the hip function can be recovered in a short time, which can effectively guarantee the quality of life of patients in the process of postoperative recovery, it can promote the rapid improvement of inflammatory reaction symptoms of patients after surgery, and help to improve the comprehensive surgical effect of this part of patients.