经小切口外侧入路髋关节置换术治疗股骨颈骨折患者的效果

Effect of hip replacement through small incision lateral approach in the treatment of patients with femoral neck fracture

目的分析经小切口外侧入路髋关节置换术治疗股骨颈骨折患者的效果。方法选取2018年8月至2020年8月我院收治的95例股骨颈骨折患者作为研究对象,根据手术方案不同将其分为对照组(n=46)和观察组(n=49)。对照组选择普通切口外侧入路髋关节置换术,观察组选择小切口外侧入路髋关节置换术。比较两组的治疗效果。结果观察组的切口小于对照组,术后失血量、术后引流量少于对照组,手术时间、住院时间短于对照组(P<0.05)。术后1 d、1周、1个月,观察组的疼痛数字评分法(NRS)评分低于对照组(P<0.05)。观察组的并发症总发生率低于对照组,差异具有统计学意义(P<0.05)。观察组的髋关节功能恢复优良率高于对照组,差异具有统计学意义(P<0.05)。术后3个月,两组的健康状况调查简表(SF-36)评分均升高,且观察组高于对照组(P<0.05)。术后3 d,观察组的皮质醇(COR)、去甲肾上腺素(NE)、肾上腺素(E)、P物质(SP)及前列腺素E_(2)(PGE_(2))水平明显低于对照组(P<0.05)。结论小切口外侧入路髋关节置换术治疗股骨颈骨折患者具有创伤小、术后疼痛程度低优势,可缩短术后康复进程,减少相关并发症,改善髋关节功能,减轻应激反应,提高生活质量。

Objective To analyze the effect of hip replacement through small incision lateral approach in the treatment of patients with femoral neck fracture.Methods A total of 95 patients with femoral neck fracture admitted in our hospital from August 2018 to August 2020 were selected as the research objects,and the patients were divided into control group(n=46)and observation group(n=49)according to different surgical schemes.The control group chose ordinary incision lateral approach hip replacement,and the observation group chose small incision lateral approach hip replacement.The therapeutic effects of the two groups were compared.Results The incision of the observation group was smaller than that of the control group,the postoperative blood loss and postoperative drainage volume were less than those of the control group,and the operation time and hospitalization time were shorter than those of the control group(P<0.05).At 1 d,1 week and 1 month after operation,the Numerical Rating Scale(NRS)score of the observation group was lower than that of the control group(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The excellent and good rate of hip joint function recovery in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).At 3 months after operation,the 36-Item Short Form Health Survey(SF-36)scores of the two groups increased,and those in the observation group were higher than the control group(P<0.05).At 3 d after operation,the levels of cortisol(COR),norepinephrine(NE),epinephrine(E),substance P(SP)and prostaglandin E_(2)(PGE_(2))in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The small incision lateral approach hip replacement for patients with femoral neck fracture has the advantages of small trauma and low postoperative pain,which can shorten the postoperative rehabilitation process,decrease related complications,improve hip joint function,reduce stress response and enhance quality of life.