人工股骨头置换与全髋关节置换术治疗老年人移位型股骨颈骨折的3年随访疗效比较  

A comparison of 3 years follow-up on hemiarthroplasty and total hip arthroplasty for the treatment of the displaced fracture of femoral neck

作　　者：赵会[1] 周君琳[1] 刘清和[1] 陆铁[1] 尹博[1] 单磊[1] 刘洋[1] 李一汉[1] 

机构地区：[1]首都医科大学附属北京朝阳医院骨科,100020

出　　处：《北京医学》2015年第11期1022-1024,共3页Beijing Medical Journal

摘　　要：目的探讨人工股骨头置换术和全髋关节置换术治疗老年移位型股骨颈骨折患者的临床疗效。方法回顾性分析我院2010年1月至2012年1月收治的82例65岁以上老年移位型股骨颈骨折病例,其中47例采用人工股骨头置换术,35例采用人工全髋关节置换术,总结分析两组患者手术持续时间、术中出血量、术后引流量、早期并发症,并对所有患者进行追踪随访,采用Harris评分评价中短期治疗效果。结果人工股骨头置换术组手术时间(38.9+9.1)min,明显短于全髋关节置换术组的(62.7±10.1)min;人工股骨头置换术组术中出血量为(381.4±79.5)ml,明显少于全髋关节置换术组的(478.5±118.6)ml;人工股骨头置换术组术后引流量(124.3±26.1)ml,明显少于全髋关节置换术组(138.2±18.1),差异均有统计学意义(P<0.05)。人工股骨头置换术组患者术后早期并发症发生率为12.8%,全髋关节置换术组为11.4%,差异无统计学意义(P>0.05)。本组患者术后随访3年,术后1年两组患者Harris评分及优良率(77.1%vs.76.6%)差异无统计学意义(P=0.542);术后3年全髋关节置换术组Harris评分及优良率(51.4%vs.38.3%)明显高于人工股骨头置换术组,两组比较差异有统计学意义(P=0.001)。结论两种术式各具优缺点,近期效果基本相同,全髋关节置换术中期效果优于人工股骨头置换术。Objective To evaluate the 3 years follow-up therapeutic effect of femoral neck displaced fracture in elderly patients. Methods Eighty-two patients older than 65 years old with femoral neck fracture from January 2010 to January 2012, were treated with total hip arthroplasty（35 patients） and hemiarthroplasty（47 patients）. The operation time,volume of blood loss, postoperative drainage and early complications were evaluated. And the Harris evaluation system was applied to check the efficacy of the two operative procedures. Results Hemiarthroplasty operation cost less time[（38.9 ± 9.1）min vs.（62.7 ± 10.1）min], less blood loss[（381.4 ± 79.5）ml vs.（478.5 ± 118.6）ml], less postoperative drainage[（124.3 ± 26.1）ml vs.（138.2 ± 18.1）ml]. The early complication rate was 12.8% in hemiarthroplasty operation group and11.4% in the total hip arthroplasty group. And no significant difference was detected between the two groups. After more than 3 years of follow up and the comparison by Harris evaluation system, no difference was detected after 1 year post-operation and significant difference was detected 3 year after operation. Conclusion The two operation procedures for femoral neck fracture have advantages and disadvantages. The early effect is similar between the two treatments and the total hip arthroplasty has better effect on 3 years follow up.

关 键 词：人工股骨头置换术 全髋关节置换术 老年 股骨颈骨折 

分 类 号：R687.4[医药卫生—骨科学]