双动全髋关节置换与传统全髋关节置换治疗移位性股骨颈骨折的疗效对比研究  

Comparison of clinical curative effects between dual articulation cups and conventional THA for displaced femoral neck fractures

作　　者：陶岳峰[1] 潘宏[1] 王凌志[1] 曹燕庆[1] 陈诚[1] 刘金锐[1] Yue-feng Tao Hong Pan Ling-zhi Wang Yan-qing Cao Cheng Chen Jin-rui Liu(Department of Orthopaedics, A nqing Municipal Hospital of A nhui Province, A nqing, A nhui 246003, Chin)

机构地区：[1]安徽省安庆市立医院骨科,安徽安庆246003

出　　处：《中国现代医学杂志》2016年第24期105-109,共5页China Journal of Modern Medicine

摘　　要：目的评价双动全髋关节置换与传统全髋关节置换治疗移位性股骨颈骨折的临床效果。方法选取2013年3月-2015年3月在安徽省安庆市立医院就诊的49例移位性股骨颈骨折的患者作为研究对象，随机将其分为实验组和对照组，实验组采取双动全髋关节置换治疗，对照组采取传统全髋关节置换治疗。记录和比较两组患者手术时间、术中出血量、术后下床时间及围手术期并发症。采用Harris评分评估术前及术后髋关节功能，运用欧洲生活质量评分EQ-5D评分体系评定患者的健康生活质量。行x线检查判断假体是否松动、下沉。结果所有患者均获得随访，随访时间为12～26个月（平均17．5个月）。两组患者平均手术时间、术中出血量、下床时间及围手术期并发症发生情况比较，差异无统计学意义（P〉0.05）。术前两组患者髋关节Harris评分无差异。术后两组患者的Harris评分均较术前提高，且随着随访时间的延长，评分逐渐提高。术后1、3、6、9及12个月实验组与对照组Harris评分基本接近，差异无统计学意义（P〉0．05）。至末次随访时，对照组假体脱位1例，假体松动1例，实验组未见假体松动或下沉病例。结论双动全髋关节置换与传统全髋关节置换对移位性股骨颈骨折都有很好的治疗效果。相比传统全髋关节置换，双动全髋关节置换可以提供良好的稳定性，术后假体松动发生率低，使用寿命更长。Objective To compare clinical curative effects of dual articulation cups and conventional THA for the treatment of displaced femoral neck fractures. Methods A total of forty-nine patients with the diagnosis of displaced femoral neck fractures selected between March 2013 and March 2015, were randomly divided into treatment group and control group. The treatment group was treated by total hip arthroplasty （THA） with dual articulation cups and the control group was treated by conventional THA. The surgical time, intraoperative blood loss, postoperative out- of-bed time and perioperative complications were recorded and compared. The Harris scores were used to evaluate the hip function preoperative and postoperative. The health-related quality of patients＂ life was evaluated with the EQ-5D index. Postoperative complications were evaluated by X-ray. Results All patients were followed up for 12 - 26 months （17.5 months on average）. The surgical time, intraoperative blood loss, postoperative out - of - bed time and perioperative complications did not differ significantly between the two groups. Before surgeries, the Harris scores of these two groups were similar. After surgery, the Harris scores of the two groups were improved. Moreover, as the duration of follow-up became longer, the scores increased gradually. The Harris scores of the treatment group were similar with the control group in the first 12 months （P 〉 0.05）. Prosthesis dislocation was found in 1 case,prosthesis loosening in 1 case in the control group before the last follow - up. No prosthesis loosening or dislocation were observed in the treatment group before the last follow-up. Conclusions Dual articulation cups and conventional THA have good therapeutic effects for the treatment of femoral neck fractures. THA with dual articulation cups can provide better stability, low incidence of postoperative prosthesis loosening and longer service life compared with conventional THA.

关 键 词：全髋关节置换 双动关节 股骨颈骨折 

分 类 号：R683[医药卫生—骨科学]