全髋关节置换术和双极人工股骨头置换术治疗老年股骨颈骨折的比较研究

Comparative Study of Total Hip Arthroplasty and Bipolar Hemiarthroplasty Treating for the Treatment of Senile Femoral neck Fracture

目的比较全髋关节置换术(THA)和双极人工股骨头置换术(BHA)治疗老年股骨颈骨折的临床疗效。方法选择2012年9月—2014年10月我院骨科收治的老年股骨颈骨折患者96例,按照手术方法不同将患者分为全髋关节置换术组(THA组)和双极人工股骨头置换术组(BHA组),每组48例。比较分析两组患者手术时间、术中失血量、术后引流量、住院时间及术后并发症;术后对患者随访3年,采用Harris评分评价手术优良率。结果两组患者手术时间、术中失血量、术后引流量及住院时间比较差异无统计学意义(P>0.05);术后随访发现,术后1年两组患者的治疗优良率差异无统计学意义(P>0.05);而在术后2年、3年,THA组患者的治疗优良率明显高于BHA组,差异均有统计学意义(P<0.05);THA组患者并发症发生率为10.42%,明显低于BHA组的47.92%(P<0.05)。结论 THA和BHA治疗老年股骨颈骨折均有较好的临床疗效,但THA有更好的远期疗效,且术后并发症少,值得临床推广应用。

OBJECTIVE To compare the clinical curative effect of total hip arthroplasty(THA) and bipolar hemiarthroplasty(BHA) in thetreatment of senile femoral neck fracture. METHODS 96 cases of elderly patients with femoral neck fracture in department of orthope-dics of our hospital from September 2012 to October 2014 were divided into total hip arthroplasty group(THA) and bipolar hemiarthro-plasty group(BHA), which there were 48 cases in each group. The operation time, intraoperative blood loss, postoperative patients withflow rate, length of hospital stay and postoperative complications of two groups were comparative analyzed; for patients with postopera-tive follow-up of 3 years,the rate of good evaluation procedure was used with the Harris scoring. RESULTS Two groups of patients inthe operation time, intraoperative blood loss, postoperative differences between flow rate and length of hospital stay had no statisticalsignificance(P>0.05); Postoperative follow-up found that the difference between two groups of patient care was no statistical signifi-cance after 1 year(P>0.05); while the rate of good evaluation of patients in THA group was significantly higher than that of BHAgroup after 2, 3 years of follow-up, which the differences were statistically significant(P<0.05); the incidence of complications was10.42% in patients with THA group was obviously lower than that of 47.92% of BHA group(P<0.05). CONCLUSION THA and BHAin the treatment of senile femoral neck fracture has good clinical efficacy,meanwhile THA has better long-dated curative effect andlower postoperative complications. It can be replicated in clinical.