全髋和半髋置换治疗老年股骨颈骨折的临床对比分析  

Clinical Analysis of Total Hip and Half hip Hemiarthroplasty in Treatment of Elderly Femoral Neck Fractures

作　　者：吴俊学[1] 蔚芃[1] 夏先学[1] 陈路[1] 蒋萍[1] 

机构地区：[1]川北医学院附属医院骨科,四川南充637000

出　　处：《现代生物医学进展》2015年第11期2102-2104,2118,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨全髋和半髋关节置换术治疗老年股骨颈骨折的临床疗效。方法:选择本院收治的70例老年股骨颈骨折患者,采用随机数字表法将其分为观察组和对照组各35例,观察组给予全髋关节置换术,对照组予以半髋关节置换术,对比两组所用手术时间、术中出血量、术后Harris评分及髋关节功能、术后并发症、疼痛率及翻修率。结果:观察组手术时间为(113.6±19.3)min,术中出血量为(432.1±32.7)ml,均显著高于对照组的(73.1±10.2)min、(201.3±30.1)m L,两组比较差异均有统计学意义(均P<0.05);观察组髋关节功能总优良率、Harris评分分别为91.43%,(91.13±5.09)分,显著优于对照组的77.14%、(80.15±4.71)分,两组比较差异均有统计学意义(均P<0.05);观察组不良反应发生率及翻修率分别为20.00%、0.00%,低于对照组的22.85%、5.71%,但差异均无统计学意义(均P>0.05);观察组疼痛率为5.71%,显著低于对照组的25.71%,两组比较差异有统计学意义(P<0.05)。结论:两种术式对股骨颈骨折的老年患者均能起到有效的治疗,均有各自的优缺点,对疼痛较为敏感和活动较多的老年患者而言,宜采用全髋关节置换术。Objective： To investigate the clinical efficacy of total hip and half hip hemiarthroplasty for elderly femoral neck fractures. Methods： 70 cases of femoral neck fracture patients in our hospital were randomly divided into observation group and control group with 35 cases in each group, the observation group was given total hip replacement while the control group was given half hip replacement, the operation time, intraoperative blood loss, postoperative Harris scores and the function of hip joint, postoperative complications, pain rate and revision rate of two groups were compared. Results： In the observation group, the operation time and the amount of bleeding was higher than those of the control group,[（113.6±19.3）min,（432.1±32.7）m L vs（73.1±10.2）min,（201.3±30.1）m L]（all P0.05）; The total excellent and good rate and Harris score of hip function assessment in the observation group was significantly better than that of control group [91.4%,（91.13±5.09） points vs 77.14%,（80.15±4.71）points]（all P0.05）; The incidence of adverse reaction and the revision rate of the observation group was lower than that of control group（20.00%, 0.00% vs 22.85%, 5.71%）, but, there was no significant difference（all P0.05）; The pain rate in observation group was 5.71%, significantly lower than 25.71% of the control group（P0.05）. Conclusion： Both two methods, with their own advantages and disadvantages, were effective in the treatment for the elderly patients with femoral neck fracture, for the elderly patients with sensitive painfulness and more activity, the total hip arthroplasty will be a prior therapy.

关 键 词：股骨颈骨折 全髋关节置换术 半髋关节置换术 疗效 

分 类 号：R683[医药卫生—骨科学]