人工髋关节置换治疗重度骨质疏松合并股骨转子间粉碎性骨折的效果  

Effect of artificial hip replacement in the treatment of severe osteoporosis complicated with comminuted intertrochanteric fracture of femur

作　　者：杨秋生 刘奋 黄元龙 YANG Qiu-sheng;LIU Fen;HUANG Yuan-long(Department of Orthopedics,the Fourth People′s Hospital of Nanhai District in Foshan City,Guangdong Province,Foshan 528211,China)

机构地区：[1]广东省佛山市南海区第四人民医院骨科

出　　处：《中国当代医药》2019年第19期129-131,135,共4页China Modern Medicine

基　　金：广东省佛山市卫生和计划生育局医学科研项目(2015203)

摘　　要：目的探讨人工髋关节置换治疗重度骨质疏松合并股骨转子间粉碎性骨折的效果。方法通过抽签的方式选取2016年2月~2018年10月于我院治疗的90例重度骨质疏松合并股骨转子间粉碎性骨折患者作为研究对象,并按照随机、双盲、对照原则的相关要求将其分为A组、B组、C组,每组各30例。A组患者予以动力髋螺钉(DHS)方案治疗,B组患者予以防旋股骨近端髓内钉(PFNA)方案治疗,C组患者则予以人工髋关节置换治疗。比较三组患者的切口长度、术中失血量、术中用时、非负重行走时间、住院时间、术后3个月Harris髋关节功能评分。结果B组患者的切口长度、术中用时均明显短于A组、C组,术中失血量明显少于A组、C组,差异有统计学意义(P<0.05);A组与C组患者的切口长度、术中失血量、术中用时比较,差异无统计学意义(P>0.05)。C组患者的非负重行走时间及住院时间均明显短于A组、B组,Harris髋关节功能评分明显高于A组、B组,差异有统计学意义(P<0.05);A组与B组患者的非负重行走时间、住院时间及Harris髋关节功能评分比较,差异无统计学意义(P>0.05)。结论重度骨质疏松合并股骨转子间粉碎性骨折患者采取三种方案治疗各有优缺点,和其他两种手术方案相比,人工髋关节置换治疗的骨折愈合速度更快,效果更确切,因此更宜作为重度骨质疏松合并股骨转子间粉碎性骨折的首选方案。Objective To investigate the effect of artificial hip replacement in the treatment of severe osteoporosis complicated with comminuted intertrochanteric fracture of femur. Methods Ninety patients with severe osteoporosis and comminuted intertrochanteric fracture of femur treated in our hospital from February 2016 to October 2018 were selected as the research subjects by lottery, and they were divided into group A, group B and group C according to the requirements of randomized, double-blind, and contrasted principles, with 30 cases in each group. Patients in the group A were treated with dynamic hip screw (DHS) regimen, patients in the group B were treated with proximal femoral nail anti-rotation (PFNA) regimen, and patients in the group C were treated with artificial hip replacement. The incision length, intraoperative blood loss, intraoperative time, non-weight-bearing walking time, hospitalization time, and Harris hip function score were compared among the three groups. Results The incision length and intraoperative time of group B were significantly shorter than those of group A and group C, the intraoperative blood loss was significantly less than that of group A and group C, and the differences were statistically significant (P<0.05). There were no significant differences in the length of incision, intraoperative blood loss and intraoperative time between group A and group C (P>0.05). The non-weight-bearing walking time and hospitalization time of group C were significantly shorter than those of group A and group B, the Harris hip function score was significantly higher than that of group A and group B, and the differences were statistically significant (P<0.05). There were no significant differences in the non-weight-bearing walking time, hospitalization time and Harris hip function score between group A and group B (P>0.05). Conclusion There are advantages and disadvantages of three schemes for severe osteoporosis complicated with comminuted intertrochanteric fracture of femur. Compared with the other two

关 键 词：重度骨质疏松合并股骨转子间粉碎性骨折 动力髋螺钉 防旋股骨近端髓内钉 人工髋关节置换 疗效 

分 类 号：R687.3[医药卫生—骨科学]