不同方法治疗老年股骨颈骨折的生活质量评价  

Life quality evaluation on femoral neck fractures in the elderly treated by different methods

作　　者：尹宏[1] 钱卫庆[1] 蒋卫方[1] 孙欣[1] 童凯[1] 

机构地区：[1]南京中医药大学第三附属医院,南京210001

出　　处：《中华中医药杂志》2009年第5期676-678,共3页China Journal of Traditional Chinese Medicine and Pharmacy

摘　　要：目的:评价应用多枚AO加压空心螺钉内固定、人工股骨头置换、人工全髋关节置换,3种不同方法治疗老年移位股骨颈骨折后疗效和生活质量。方法:回顾性分析本院1998-2002年收治的60岁以上获随访患者106例,其中34例为AO空心加压螺钉内固定、35例人工股骨头置换和37例全髋人工关节治疗。用Harris评分法评定手术侧髋关节的疼痛、活动度和运动情况。采用欧洲生活质量评分EQ-5D评分体系评定病人的健康生活质量评分评价1年和6年时3组间疼痛、日常生活功能等项差异。结果:术后1年日常生活及关节功能方面,人工股骨头组(B组)和全髋人工关节关节置换组(C组)优于内固定组(A组),术后6年时B组与A组差异无统计学意义,且2者均较C组差。结论:与骨折内固定相比,对于手术前健康状况良好的伴有移位的老年股骨颈骨折病人,初次全髋关节置换具有并发症发生率低、髋关节功能恢复好、健康生活质量好等优点,值得推广。Objective： To evaluate the results of displaced neck with internal fixation （AO compress cannulated screws）,artificial femoral head replacement and total hip replacement. Methods： From 1998 to June 2002,106 elderly patients of over sixty years old with femoral neck fracture were operated with AO compress cannulated screws（34 cases）, artificial femoral head replacement（35 cases） or total hip replacement（37 cases）. The hip function, including the pain, movement and walking, was evaluated by the Harris scoring system. The health-related quality of patients＇ life in every group, including the pain, function of daily living,and so on, was evaluated by using the EQ-5D index in first and sixth year after operation. Results： The Joint function of artificial femoral head replacement group（B group） and total hip replacement group（C group） was significantly superior to internal fixation group（A group） in the first year. But, in the sixth year, there was no significant difference between group B and group A, and the clinical efficacy of both them were inferior to group C. Conclusion： Compared with internal fixation, primary total hip replacement provides a better outcome for mentally competent elderly patients with a displaced femoral neck fracture. Total hip replacement is worth being recommended for elderly patients.

关 键 词：股骨颈骨折 骨折固定术 髋关节置换术 

分 类 号：R687.3[医药卫生—骨科学]