不同材料髋关节假体置换在老年股骨转子间骨折中的应用研究  

Study on application of different material hip prosthesis replacement in elderly femoral intertrochanteric fractures

作　　者：高健[1] 沈志敏[1] 王国胜[1] 续斌[1] GAO Jian ;SHEN Zhimin;WANG Guosheng;XU Bin(Department of Joint Surgery,the Sixth Affiliated Hospital,Xinjiang Medical University,Urumqi 830002,China)

机构地区：[1]新疆医科大学第六附属医院关节外科,新疆乌鲁木齐830002

出　　处：《中国现代医生》2018年第17期17-20,共4页China Modern Doctor

摘　　要：目的研究不同材料髋关节假体置换在老年股骨转子间骨折中的应用。方法选取2014年2月～2016年5月间我院收治的90例不稳定股骨转子间骨折患者进行研究,按随机数字表分为观察组与对照组,各45例。对照组患者采用骨水泥型假体,观察组采用生物型假体。比较两组术中出血量、手术时间、下床活动时间、术后引流量、手术前后髋关节Harris评分、术后6个月的髋关节优良率、异位骨化情况、假体稳定性、不良事件总发生率。结果两组术中出血量、手术时间、下床活动时间、术后引流量等围手术期指标差异均无统计学意义(P>0.05)。两组手术前及术后不同时间点的髋关节Harris评分均无统计学意义(P>0.05)。观察组与对照组髋关节优良率分别为71.11%、75.56%,差异无统计学意义(P>0.05)。两组术后6个月异位骨化情况比较无统计学意义(P>0.05)。观察组假体稳定性达100.00%,高于对照组86.67%(P<0.05)。观察组不良事件总发生率为4.44%,高于对照组20.00%(P<0.05)。结论生物型假体在老年股骨转子间骨折患者髋关节假体置换术中的应用可取得与骨水泥固定相当的髋关节功能,且假体稳定性与安全性高,值得推广。Objective To study the application of hip replacement of different materials in the treatment of femoral intertrochanteric fractures in the elderly.Methods A total of 90 patients with unstable intertrochanteric fractures treated in our hospital from February 2014 to May 2016 were selected for study.Randomized numbers were used to dividepatients into observation group and control group,45 cases in each group.The cemented prosthesis was used in the control group and the bioprosthesis was used in the observation group.The intraoperative blood loss,operation time,ambulation time,postoperative drainage volume,Harris hip score before and after surgery,excellent hip joint rate after 6 months,heterotopic ossification,and prosthesis stability and the total incidence of adverse events were compared.Results There were no significant differences in perioperative indexes such as intraoperative blood loss,operation time,ambulation time,and postoperative drainage volume between the two groups(P>0.05).There was no statistically significant difference in hip scores between the two groups before and after surgery(P>0.05).The excellent rate of hip joints in the observation group and the control group were 71.11%and 75.56%,respectively,and the difference was not statistically significant(P>0.05).There was no statistically significant difference in heterotopic ossification between the two groups at 6 months postoperatively(P>0.05).In the observation group,the stability of the prosthesis was 100.00%,which was higher than that of the control group(86.67%)(P<0.05).The overall incidence of adverse events in the observation group was 4.44%,which was higher than that of the control group 20.00%(P<0.05).Conclusion The application of bioprosthesis in the replacement of hip joint prostheses in elderly patients with femoral intertrochanteric fractures can achieve hip joint function equivalent to that of cement fixation.The stability and safety of prosthesis are high and worthy of promotion.

关 键 词：股骨转子间骨折 老年 髋关节假体置换 骨水泥 生物固定型假体 

分 类 号：R687.3[医药卫生—骨科学]