人工髋关节置换术与内固定治疗股骨颈骨折的疗效及安全性分析

Efficacy and safety analysis of artificial hip replacement and internal fixation in treatment of femoral neck fracture

目的分析人工髋关节关节置换术与内固定治疗股骨颈骨折(FNF)的疗效及安全性。方法选取2016年9月至2019年9月于本院就诊的90例FNF患者作为研究对象,按照随机数字表法分为研究组和对照组,每组45例。研究组给予人工髋关节置换术治疗,对照组给予骨折内固定治疗,比较两组临床疗效、临床手术指标、髋关节功能Harris评分及术后并发症发生情况。结果研究组治疗总有效率为91.11%,高于对照组的75.56%,差异有统计学意义(P<0.05)。研究组手术时间长于对照组,术中出血量多于对照组,下床活动时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗前,两组Harris评分比较差异无统计学意义;治疗后,研究组Harris评分为(76.22±15.36)分,高于对照组的(59.46±13.47)分,差异有统计学意义(P<0.05)。研究组并发症发生率为17.17%,低于对照组的42.22%,差异有统计学意义(P<0.05)。结论与内固定比较,人工髋关节置换术虽手术时间较长,术中出血量较多,但患者术后髋关节功能恢复快且稳定,并发症少,疗效确切,应用前景良好。

Objective To analyze the efficacy and safety of hip replacement and internal fixation in the treatment of femoral neck fracture(FNF).Methods A total of 90 patients with FNF who visited our hospital from September 2016 to September 2019 were selected as the research subjects,and they were divided into study group and control group according to the random number table method,with 45 cases in each group.The study group was treated with artificial hip replacement and the control group was given internal fixation of fractures,and the clinical efficacy,clinical surgical indicators,Harris score of hip function and postoperative complications between the two groups were compared.Results The total effective rate of treatment in the study group was 91.11%,which was higher than 75.56%of the control group,and the difference was statistically significant(P<0.05).The operation time in the study group was longer than the control group,intraoperative blood loss was more than that in the control group,and the time of getting out of bed and hospital stay were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in Harris scores between the two groups;after treatment,the Harris score in the study group was(76.22±15.36)scores,which was higher than that of the control group(59.46±13.47)scores,and the difference was statistically significant(P<0.05).The incidence of complications in the study group was 17.17%,which was lower than 42.22%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with internal fixation,although hip replacement takes longer operation time and has more intraoperative bleeding,the postoperative hip function recovery is fast and stable,the complications are few,the curative effect is certain,and the application prospect is good.