人工股骨头置换术与人工全髋关节置换术治疗老年股骨颈骨折的临床效果分析

Clinical Effects of Artificial Femoral Head Replacement and Total Hip Re⁃placement in the Treatment of Femoral Neck Fracture in Elderly Patients

目的探究对老年股骨颈骨折患者应用人工股骨头置换术与人工全髋关节置换术的效果。方法回顾性选取2017年1月—2022年5月高邮市中医医院收治的238例股骨颈骨折患者的临床资料,依据治疗方案不同分为对照组(n=132)和观察组(n=106)。对照组实施人工股骨头置换术治疗,观察组实施人工全髋关节置换术治疗,比较两组治疗效果、临床相关指标、髋关节功能评分(Harris Hip Score,HHS)、髋关节疼痛程度评分(Visual Analogue Scale,VAS)、并发症。结果观察组治疗效果(96.23%)高于对照组(89.39%),差异有统计学意义(χ^(2)=3.926,P<0.05)。与对照组相比,观察组手术时间、住院时间较长,术中出血量、术后引流量较多,差异有统计学意义(P<0.05)。术后1年,观察组HHS评分高于对照组,差异有统计学意义(P<0.05)。和对照组比较,观察组各时间点VAS评分以及并发症发生率均较低,差异有统计学意义(P<0.05)。结论采用人工股骨头置换术治疗老年股骨颈骨折患者,有着手术时间短等优点,但其远期效果较差。虽然人工全髋关节置换术的手术时间等较长,但远期效果较好,疼痛感低,并发症少,可依据患者实际情况而选择手术方案。

Objective To explore the effect of artificial femoral head replacement and total hip arthroplasty in elderly patients with femoral neck fracture.Methods Clinical date of 238 patients with femoral neck fracture admitted to Gaoyou Hospital of Traditional Chinese Medicine from January 2017 to May 2022 were retrospectively selected and di⁃vided into control group(n=132)and observation group(n=106)according to different treatment plans.The control group was treated with artificial femoral head replacement,and the observation group was treated with artificial total hip replacement.The therapeutic effect,clinical correlation index,Harris Hip Score(HHS),Visual Analogue Scale(VAS)and complications were compared between the two groups.Results The therapeutic effect of observation group(96.23%)was higher than that of control group(89.39%),and the difference was statistically significant(χ^(2)=3.926,P<0.05).Compared with the control group,the operation time and hospital stay in the observation group were longer,and the intraoperative blood loss and postoperative drainage volume were larger,and the difference was statistically signifi⁃cant(P<0.05).One year after operation,the HHS score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Compared with control group,VAS score and complica⁃tion rate of observation group were lower at all time points,and the difference was statistically significant(P<0.05).Conclusion The use of artificial femoral head replacement in the treatment of elderly patients with femoral neck fracture has the advantages of short operation time,but its long-term effect is poor.Although the operation time of artifi⁃cial total hip replacement is longer,the long-term effect is better,the pain is low,and the complications are less,so the surgical plan can be selected according to the actual situation of the patient.