全髋与半髋关节置换术治疗老年移位股骨颈骨折的疗效分析  

Study on the efficacy of total hip arthroplasty or hemiarthroplasty in treatment of displaced femoral neck fractures in elderly patients

作　　者：张清华[1] 张光武[1] 栗剑[1] 刘家帮[1] 吴四军[1] 张昆[1] 姚洪春[1] 阚金富 李冬[1] 

机构地区：[1]北京大学首钢医院骨科,北京100144

出　　处：《临床和实验医学杂志》2015年第8期680-682,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的比较全髋关节置换术和半髋关节置换术治疗老年移位股骨颈骨折的临床疗效。方法回顾总结2009年1月至2011年12月手术治疗并获得随访的老年股骨颈骨折患者243例,其中半髋关节置换术137例,全髋关节置换术106例,观察比较两组患者的手术效果。结果两组患者均顺利完成手术,半髋关节置换组手术时间、术中失血量、术后引流量和术后负重时间均优于全髋关节置换组(P<0.05),术后不良事件发生率组间比较无统计学差异(P>0.05);全髋关节置换组Harris评分优良率(88.7%)高于半髋关节置换组(77.1%),组间比较差异有统计学意义(P<0.05)。结论全髋关节置换术或半髋关节置换术是治疗老年股骨颈骨折的有效方法,对于可耐受手术、预期寿命长的病人采取全髋关节置换术可能会得到更有利的功能恢复;对于身体条件差、预期寿命短的患者可使用半髋关节置换术。Objective To evaluate the curative effect of total hip arthroplasty or hemi- hip arthroplasty in treatment of elderly patients with femoral neck fractures. Methods The clinical data of 243 elderly patients with femoral neck fracture admitted in this hospital during January,2009 to December,2011 were retrospectively analyzed. Among these 243 patients,106 patients were treated by total hip arthroplasty and 137 patients were treated by artificial femoral head replacement. The operating time,amount of blood loss,postoperative drainage,duration for postoperative weight- bearing,incidence of postoperative complications and outcome of hip function（ Harris hip scores） were compared,in order to analyze the advantages and disadvantages of these two procedures. Results All these operations were successful in all these patients. Operating time,amount of intraoperative blood loss,postoperative drainage and duration for postoperative weight- bearing in patients of hemi- arthroplasty group were better than those of total hip replacement group（ P〈0. 05）. There was no significant difference in incidence rate of postoperative complications between these two groups（ P〉0. 05）. Their excellent rates of Harris scores were 88. 7% and 77. 1% respectively（ P〈0. 05）. Conclusion Both total hip replacement and hemi- arthroplasty are effective procedures for treatment of elderly patients with displaced femoral neck fractures. As for those patients with long life expectancy and good tolerance,total hip arthroplasty is more favorable for functional condition,on the contrary,hemi- arthroplasty is more adequate.

关 键 词：老年人 股骨颈骨折 全髋关节置换 半髋关节置换 

分 类 号：R687.4[医药卫生—骨科学]