髋关节置换在老年股骨粗隆间骨折中的应用效果

Application effect of hip replacement in elderly patients with intertrochanteric fracture

目的 探析髋关节置换在老年股骨粗隆间骨折中的应用价值。方法 选择2021年3月至2022年3月景德镇市第三人民医院收治的75例股骨粗隆间骨折的老年患者作为研究对象,按计算机随机数法分为对照组(n=37)和研究组(n=38)。其中对照组患者实施股骨近端防旋髓内钉(PFNA)内固定治疗,研究组患者采用髋关节置换,评估两组临床应用效果,比较两组髋关节功能,比较两组临床观察指标(包括手术时间、术中出血量、住院时间、住院费用),两组生活质量及不良反应发生率。结果 研究组患者治疗后髋关节功能优良率高于对照组,差异有统计学意义(P<0.05)。研究组患者的手术时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。研究组患者术中出血量和住院费用均少于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的日常行为、休息情况、器官功能、情感状态评分比较,差异无统计学意义(P>0.05);治疗后,两组患者的日常行为、休息情况、器官功能、情感状态评分均高于治疗前,且研究组患者的日常行为、休息情况、器官功能、情感状态评分均高于对照组,差异有统计学意义(P<0.05)。研究组患者治疗后的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论临床治疗老年股骨粗隆间骨折中采用髋关节置换治疗效果更好,可缩短手术时间和住院时间,减少术中出血量,提高患者髋关节功能和生活质量,减少患者经济负担,降低术后不良反应的发生率。

Objective To explore the application value of hip replacement in elderly patients with intertrochanteric fracture of femur.Methods From March 2021 to March 2022,75 elderly patients with intertrochanteric fracture of femur who were admitted to the Third People's Hospital of Jingdezhen City were selected as the research objects.They were divided into the control group(n=37)and the study group(n=38)according to the computer random number method.The patients in the control group were treated with proximal femoral nail antirotation(PFNA)internal fixation,and the patients in the research group were treated with hip replacement.The clinical application effects of the two groups were evaluated,the hip joint functions of the two groups were compared,the clinical observation indicators of the two groups were compared(including operation time,intraoperative bleeding,hospital stay,hospital costs),the quality of life and the incidence of adverse reactions of the two groups were compared.Results The excellent and good rate of hip joint function in the study group was higher than that in the control group,with statistically significant difference(P<0.05).The operation time and hospitalization time of the patients in the study group were shorter than those in the control group,with statistically significant differences(P<0.05).The amount of intraoperative bleeding and hospitalization expenses of the patients in the study group were lower than those in the control group,with statistically significant differences(P<0.05).Before treatment,there were no significant differences between the two groups in daily behavior,rest,organ function and emotional state scores(P>0.05).After treatment,the scores of daily behavior,rest,organ function and emotional state of patients in both groups were higher than those before treatment,and the scores of daily behavior,rest,organ function and emotional state of patients in the study group were higher than those in the control group,with statistically significant differences(P<0.05).The total incidence of adverse reactions in the study group was lower than that in the control group, with statistically significant difference (P<0.05). Conclusion In the clinical treatment of elderly intertrochanteric fracture of femur, hip replacement has a better effect, which can shorten the operation time and hospitalization time, reduce the amount of intraoperative bleeding, improve the hip joint function and quality of life, reduce the economic burden of patients, and reduce the incidence of adverse reactions after surgery.