老年股骨颈骨折髋关节置换术时机选择与临床疗效及预后分析  

Analysis of the Operation time,Clinical Effect and Prognosis of Total Hip Arthroplasty in Elderly Patients with Femoral Neck Fracture

作　　者：肖卫东[1] 喻爱喜[1] 潘振宇[1] 陶圣祥[1] 漆白文[1] 胡祥[1] YU Aixi;PAN Zhenyu(Zhongnan Hospital of Wuhan University, Hubei WuHan 430071, China)

机构地区：[1]武汉大学中南医院骨科,湖北武汉430071

出　　处：《河北医学》2019年第4期643-648,共6页Hebei Medicine

基　　金：湖北省自然科学基金面上项目;(编号:2011CDB516)

摘　　要：目的:探讨老年股骨颈骨折髋关节置换术不同手术时机对临床疗效与预后的影响。方法:回顾性分析在我科行股骨颈骨折髋关节置换手术的患者180例,按不同手术时间分为A组60例(手术时间为骨折后24h内)、B组60例(手术时间为骨折后1～3d)和C组60例(手术时间为骨折后3d以上)。比较3组术中出血量、手术时间、住院时间、术后并发症的发生情况、术后髋关节Harris评分情况及总体疗效。结果:B组术后3、6和9个月Harris功能评分均显著高于C组(P<0.05); A组术后Harris功能评分明显高于同时点C组(P <0.05),术后6和9个月Harris功能评分显著高于同时点B组(P <0.05);总体疗效比较,A组显著高于C组,差异有统计学意义(P <0.05),但A与B,B与C组间比较差异比较无统计学意义(P>0.05);三组术中出血量、手术时间和住院时间比较,差异均无统计学意义(P>0.05); A组5例发生并发症,B组7例发生并发症,C组14例发生并发症,3组并发症的发生率比较,差异有统计学意义(P<0.05)。结论:老年股骨颈骨折髋关节置换术治疗时间越早其手术效果越好。Objective: To explore the effects of different surgical timings on hip replacement of femoral neck fractures in the elderly for clinical efficacy and prognosis. Methods: A retrospective analysis of 180 hip replacement patients undergoing femoral neck fractures in our department was performed with hip arthroplasty. All patients were divided into group A and 60 according to different operation time (operation time was 3-5 days after fracture). 60 patients in group B (operation time was 5-7 days after fracture) and 60 patients in group C (operation time was more than 7 days after fracture). The intraoperative blood loss, operation time, length of hospital stay, and postoperative complications were compared among the three groups;the Harris hip scores of the hip joints were observed, preoperatively and postoperatively;the comparison and overall efficacy were compared. Results: Harris function scores at 3, 6 and 9 months after operation in group B were significantly higher than those in group C (P<0.05). Postoperative Harris function score in group A was significantly higher than that in group C at the same time (P<0.05).) Harris function scores at 6 and 9 months after operation were significantly higher than those at the same time point in group B (P<0.05);postoperative acceptance rate in group A was significantly higher than that in group C (P<0.05);intraoperative bleeding in the three groups There was no statistically significant difference in the volume, operation time, and length of hospital stay between the three groups (P>0.05). The incidence of complications in group A and B was significantly lower than that in group C (P<0.05). Conclusion: The earlier the treatment time of hip replacement for elderly femoral neck fracture is, the better the surgical effect is.

关 键 词：股骨颈骨折 手术时机 老年 髋关节置换术 

分 类 号：R687.4[医药卫生—骨科学]