不同假体髋关节置换术治疗骨质疏松性髋关节骨折的临床疗效  

Clinical Effect on Hip Replacement with Different Prosthesis for Osteoporotic Hip Fracture

作　　者：沈小辉[1] 杨菲[1] 喻伟[1] 刘志刚[2] SHEN Xi- ao-hui YANG Fei YU Wei LIU Zhi-gang(Department of Trauma Surgery, Dongfeng Hospital, Hubei University of Medicine, Shiyan 442000, Hubei, China Department of Orthopedics, Dongfeng Hospital, Hubei University of Medicine, Shiyan 442000, Hubei , China)

机构地区：[1]湖北医药学院附属东风医院创伤外科,十堰442000 [2]湖北医药学院附属东风医院骨科,十堰442000

出　　处：《中国现代手术学杂志》2017年第1期36-39,共4页Chinese Journal of Modern Operative Surgery

基　　金：2014年十堰市科学技术研究与开发项目(编号:14Y50)

摘　　要：目的探讨不同假体髋关节置换术治疗骨质疏松性髋关节骨折的临床疗效。方法选取2013年4月~2015年12月我院收治的骨质疏松性髋关节骨折患者76例,随机分为两组,各38例,均行髋关节置换术,观察组行生物固定假体植入治疗,对照组行骨水泥假体植入治疗。比较两组预后情况。结果所有患者均顺利完成手术,无术中严重并发症发生。术后3个月观察组与对照组的Harris评分优良率分别为92.1%和68.4%,切口感染、神经损伤、肺部感染、下肢静脉血栓等并发症发生率分别为5.3%和28.9%,差异均有统计学意义(P<0.05)。术后3个月观察组与对照组髋关节活动度分别为164.22°±22.16°和134.24°±19.92°,较术前的69.33°±15.29°和71.39°±16.02°明显改善(P<0.05),且观察组明显优于对照组(P<0.05)。结论相对于骨水泥型假体,基于生物型假体的下肢重建在骨质疏松性髋关节骨折置换术的应用能提高术后关节活动度,改善髋关节功能,减少并发症的发生,从而促进患者早日康复。Objective To discuss the clinical effects of different hip prosthesis during the hip replacement in the treatment of osteoporotic hip fractures. Methods From April 2013 to December 2015, a total of 76 patients with osteoporotic hip fractures were randomized into the observation group and the control group, with 38 patients for each. All patients were carried out the hip replacement. The observation group was performed the bioprosthesis implantation, and the control group was performed bone cemented prosthesis implantation. Results All patients were successfully completed the hip replacement without serious complications. Three months after the surgery, the Harris score of postoperative outcome was 92.1% and 68.4% respectively, and the postoperative complications rate such as infection, nerve injury, pulmonary infection and phlebothrombosis of lower limb was 5.3% and 28.9% respectively in the observation group and the control group, there were statistical differences between two groups （ P 〈 0.05 ）. The hip activity of the observation group and the control group was 164.22° ±22.16°and 134.24° ± 19.92°respectively 3 months after the surgery, both were improved obviously than 69.33° ± 15.29°and 71.39° ± 16.02°of preoperation （P 〈0.05）. And the hip activity was better in the observation group than that in the control group （P 〈 0. 05）. Conclusion Compares with the bone cement prosthesis, application of lower extremity reconstruction based on bioprosthesis fixation can im- prove the postoperative hip joint activities and hip function for the treatment of osteoporotie hip fractures, it also can reduce the complications and promote early rehabilitation of the patients.

关 键 词：髋骨折 关节成形术 置换 髋 生物假体 骨质疏松 

分 类 号：R687.4[医药卫生—骨科学] R580[医药卫生—外科学]