两种类型人工股骨头置换治疗老年人Garden Ⅲ、Ⅳ型股骨颈骨折的疗效对照分析  

Comparative analysis of therapeutic effect between two types of artificial femoral head replacement in treatment of Garden Ⅲ and Ⅳ femoral neck fracture in the elderly

作　　者：陈喜锋[1] 马文芳[1] 

机构地区：[1]连云港市中医院骨科,江苏222004

出　　处：《创伤外科杂志》2017年第12期940-942,共3页Journal of Traumatic Surgery

摘　　要：目的探讨两种类型人工股骨头置换治疗老年人GardenⅢ、Ⅳ型股骨颈骨折的临床效果。方法回顾性分析连云港市中医院2011年1月—2016年6月收治的78例老年股骨颈GardenⅢ、Ⅳ型骨折患者,其中40例患者选择骨水泥型人工股骨头置换(骨水泥组),38例患者选择生物型人工股骨头置换(生物型组),对比两组患者术中术后及髋关节功能恢复情况。结果生物型组的手术时间短于骨水泥组(P<0.05),生物型组的术中出血量、术后引流量、下地活动时间、康复训练时间、术后负重时间、输血率、输血量均显著高于或晚于骨水泥组(P<0.05);术后3个月,生物型组的Harris评分低于骨水泥组(P<0.05);术后6个月,两组患者的Harris评分差异无统计学意义(P>0.05);两组患者术后6个月的Harris评分较术后3个月差异有统计学意义(P<0.05);术后6个月,骨水泥组的髋关节功能优良率95.00%与生物型组的89.47%差异无统计学意义(P>0.05)。结论骨水泥型和生物型人工股骨头置换对GardenⅢ、Ⅳ型股骨颈骨折均具有较好的效果,但是骨水泥型人工股骨头利于患者术后早期进行康复训练,功能恢复更快。Objective To explore the clinical efficacy between two types of artificial femoral head replacement in the treatment of elderly patients with Garden Ⅲ and Ⅳ femoral neck fractures.Methods A retrospective analysis of 78 elderly patients with femoral neck Garden Ⅲ and Ⅳ fractures admitted to Lianyungang Hospital of Traditional Chinese Medicine from Jan.2011 to Jun.2016 was performed.Forty patients were treated with cemented artificial femoral head replacement（bone cement group） and 38 patients were treated with biological artificial femoral head replacement（biotype group）.The intraoperative and postoperative indexes and hip function recovery were compared between the two groups.Results The operation time of the biotype group was shorter than that of the bone cement group（P0.05）.The intraoperative blood loss,postoperative drainage volume,activity time,rehabilitation training time,postoperative weight bearing time,blood transfusion rate and transfusion volume in the biotype group were significantly higher or later than those in the bone cement group（P0.05）.At 3 months after operation,the Harris score of the biotype group was lower than that of the bone cement group（P0.05）.At 6 months after operation,there was no significant difference in Harris score between the two groups（P0.05）.The Harris scores at 6 months after operation in both groups were significantly different from those at 3 months after operation（P0.05）.At6 months after operation,the excellent and good rate of hip function was 95.00% in the cemented group and 89.47%in the biotype group,and the difference was not statistically significant（P0.05）.Conclusion Both bone cement and biological artificial femoral head replacement have good effect on femoral neck fractures of Garden type Ⅲ and type Ⅳ,but cemented artificial femoral head is beneficial to early rehabilitation training,and its function recovery is earlier.

关 键 词：股骨颈骨折 人工股骨头 置换术 骨水泥 生物型 

分 类 号：R683.42[医药卫生—骨科学]