人工髋关节置换术治疗老年股骨粗隆间骨折的临床效果观察

Observation on the clinical effect of artificial hip replacement in the treatment of intertrochanteric fracture of the femur in the elderly

目的 探讨人工髋关节置换术对于老年股骨粗隆间骨折的治疗效果。方法 80例老年股骨粗隆间骨折患者,采用随机数字表法分为对照组和观察组,每组40例。对照组患者选择股骨近端防旋髓内钉(PFNA)内固定治疗,观察组患者选择人工髋关节置换术治疗。比较两组的手术情况、术后并发症发生情况、髋关节功能、生活质量评分。结果 观察组手术时间(51.26±7.25)min、住院时间(13.54±2.63)d、术后下地时间(3.22±1.24)d短于对照组的(74.86±8.25)min、(21.03±2.68)d、(7.85±1.65)d,术中出血量(452.36±60.25)ml多于对照组的(365.82±63.22)ml(P<0.05)。观察组术后并发症发生率2.50%明显低于对照组的15.00%(P<0.05)。观察组术后15 d、3个月的Harris髋关节评分(85.63±5.24)、(90.36±3.22)分明显高于对照组的(71.23±5.28)、(85.96±3.36)分(P<0.05);两组术后6个月Harris髋关节评分比较无明显差异(P>0.05)。术后6个月,两组日常行为、休息情况、器官功能、情感状态评分相比术前均有所增加,且观察组明显高于对照组(P<0.05)。结论 对于老年股骨粗隆间骨折患者而言,人工髋关节置换术具备较佳的临床疗效,并发症发生率较低,有利于改善髋关节功能,建议临床采纳。

Objective To explore the effect of artificial hip replacement in the treatment of intertrochanteric fracture of the femur in the elderly.Methods 80 elderly patients with intertrochanteric fracture of the femur were divided into a control group and an observation group according to random number table method,with 40 cases in each group.The control group was treated with proximal femoral nail anti-rotation(PFNA),and the observation group was treated with artificial hip replacement.The surgical status,occurrence of postoperative complications,hip function and quality of life score were compared between the two groups.Results The observation group had operation time of(51.26±7.25)min,hospitalization time of(13.54±2.63)d and postoperative ambulation time of(3.22±1.24)d,which were shorter than(74.86±8.25)min,(21.03±2.68)d and(7.85±1.65)d in the control group;the observation group had more intraoperative blood loss of(452.36±60.25)ml than(365.82±63.22)ml in the control group(P<0.05).The incidence of postoperative complications in the observation group was 2.50%,which was significantly lower than 15.00%in the control group(P<0.05).The Harris hip scores in the observation group were(85.63±5.24)and(90.36±3.22)points at 15 d and 3 months after surgery,which were significantly higher than(71.23±5.28)and(85.96±3.36)points in the control group(P<0.05).There was no significant difference in Harris hip score at 6 months after surgery between the two groups(P>0.05).At 6 months after surgery,the scores of daily behavior,rest,organ function and emotional state in both groups increased compared with those before surgery,and the observation group was significantly higher than the control group(P<0.05).Conclusion For the elderly patients with intertrochanteric fracture of the femur,artificial hip replacement has a better clinical efficacy,lower incidence of complications,and is conducive to to the improvement of hip function.So it is recommended for clinical adoption.