生物型与骨水泥型人工半髋关节假体治疗老年股骨颈骨折的效果及并发症比较

Comparison of the effects and complications of biotype and cement-based artificial hip prosthesis in the treatment of femoral neck fracture in the elderly

目的 比较生物型与骨水泥型人工半髋关节假体治疗老年股骨颈骨折的临床效果及并发症发生情况.方法 选择我院收治的70例老年股骨颈骨折患者作为研究对象,将患者应用随机数字表分为骨水泥型组35例和生物型组35例.分别实施骨水泥型人工半髋关节置换术和生物型人工半髋关节置换术治疗.比较两组患者围手术期临床相关指标及随访指标的差异.结果 骨水泥型组手术时间(61.2±11.3)min长于生物型组(53.3±10.4)min,差异有统计学意义(P<0.05);但术后部分负重时间(4.0±1.6)d、术后完全负重时间(30.3±6.8)d及住院时间(18.2±2.4)d明显短于生物型组(20.7±2.2) d,差异均有统计学意义(P均<0.05);术中出血量(175.3±40.3)ml及术后出血引流量(120.4±33.2)ml均少于生物型组(213.3±30.4)ml、(185.5±26.6)ml(P<0.05).骨水泥型并发症总发生率11.43%(4/35)明显低于生物型组34.29%(12/35),差异有统计学意义(P<0.05).骨水泥型组术后6个月髋关节Harris功能评分(Harris)及巴氏日常生活功能量表(Barthel 指数)评分明显高于生物型组(P<0.05);髋关节功能恢复优良率明显高于生物型组(P<0.05).结论 与生物型人工半髋关节假体相比,骨水泥型人工半髋关节假体具有临床症状改善快、预后好、相关并发症少的优点,尤其适合用于老年股骨颈骨折的治疗.

Objective To compare the effects and complications of biotype and cement-based artificial hip prosthesis in the treatment of femoral neck fracture in the elderly.Methods Seventy elderly patients with femoral neck fractures were selected as the subjects and were randomly divided into the bone-cement group(35 cases)and the biomaterials group(35 cases),the bone-cement group received cement-based artificial hip prosthesis,the biomaterials group received biotype artificial hip prosthesis,the perioperative clinical indicators and follow -up indicators of both group were compared.Results The operative time of the bone-cement group was(61.2±11.3)min,longer than that in the biomaterials group((53.3±10.4)min),the difference was statistically significant(P<0.05),while the postoperative partial load bearing time was(4.0 ± 1.6)d,the postoperative full load bearing time was(30.3 ± 6.8)d and the hospital stay time was(18.2 ± 2.4)d, significantly shorter than that in the biomaterials group((20.7 ± 2.2)d),the differences were statistically significant(P<0.05),the intraoperative blood loss((175.3±40.3)ml)and the postoperative bleeding volume ((120.4±33.2)ml)were less than those in the biomaterials group((213.3±30.4)ml,(185.5±26.6)ml) (P<0.05).The total incidence rate of bone cement complication of the bone-cement group was 11.43%,which were lower than that of the biomaterials group(34.29%),the difference was statistically significant(P<0.05) .The Harris score and Barthel life index score of the bone-cement group were significantly higher than those of the biomaterials group(P<0.05),The rate of hip function recovery was significantly higher than that of the biomaterials group(P<0.05).Conclusion Compared with the biotype artificial hip prosthesis,the cement-based artificial hip prosthesis has advantages of rapid clinical improvement, good prognosis and less complication,especially suitable for the treatment of femoral neck fracture in the elderly.