人工髋关节置换术治疗股骨粗隆间骨折患者的效果分析

Effect Analysis of Artificial Hip Arthroplasty in Patients with Intertrochanteric Fracture of Femur

目的:探讨人工髋关节置换术(AHR)治疗股骨粗隆间骨折(IFF)患者的临床效果。方法:回顾性分析2021年4月—2024年2月兴义市黔西南梧桐骨科医院收治的80例IFF患者临床资料,按手术方法的不同将其分为对照组和研究组,各40例。对照组采用股骨近端防旋髓内钉(PFNA)内固定术治疗,研究组采用AHR治疗。比较两组手术指标、疼痛程度、日常生活能力、髋关节功能及并发症发生情况。结果:研究组手术时间较对照组长,术中出血量、术后引流量均较对照组多,术后首次下床活动时间较对照组短,差异均有统计学意义(P<0.05)。术后1 d研究组疼痛视觉模拟评分较对照组高,差异均有统计学意义(P<0.05)。术后3个月,研究组Barthel指数评分、Harris髋关节功能评分量表评分均较对照组高,差异均有统计学意义(P<0.05)。研究组并发症发生率为5.00%,相较于对照组的12.50%,差异无统计学意义(P>0.05)。结论:AHR治疗IFF患者有利于尽早下床活动,利于其提升生活质量及迅速重建髋关节功能,但AHR创伤大、出血多,临床仍需慎重选择。

Objective:To investigate the clinical effect of artificial hip replacement(AHR)in the treatment of intertrochanteric fracture of femur(IFF).Methods:Data of 80 patients with IFF admitted to QianxinanWutong Orthopedic Hospital of Xingyi City from April 2021 to Febury 2024 were retrospectively analyzed.They were divided into a control group and a study group with 40 cases in each group according to different surgical methods.The control group was treated with proximal femoral nail antirotation(PFNA)internal fixation,and the study group was treated with AHR.The operative indexes,pain degree,daily living ability,hip function and complications were compared between the two groups.Results:The operation time of the study group was longer than that of the control group,the amount of intraoperative blood loss and postoperative drainage volume were more than that of the control group,and the time of getting out of bed was shorter than that of the control group,with statistical significance(P<0.05).The visual analogue score of the study group was higher than that of the control group,with statistical significance(P<0.05).Three months after surgery the scores of the Barthel Index and Harris Hip Function Scale of the study group were higher than those of the control group,with statistical significance(P<0.05).The incidence of complications in the study group was 5.00%,compared with 12.50%in the control group,with no statistical significance(P>0.05).Conclusion:The treatment of AHR in IFF patients is conducive to their early getting out of bed,improving their quality of life and rapidly reconstructing hip function.However,the treatment of AHR is traumatic and bleeding,which still needs clinical careful selection.