人工髋关节置换和空心钉内固定治疗高龄患者股骨颈骨折效果对比  

Comparison of Artificial Hip Replacement and Cannulated Internal Fixation for the Treatment of Femoral Neck Fracture in Elderly Patients

作　　者：陈能 何其泉 李健伟 CHEN Neng;HE Qi-quan;LI Jian-wei(Department of Orthopaedics, Shekou People's Hospital, Nanshan District, Shenzhen, Guangdong Province, 518067 China)

机构地区：[1]深圳市南山区蛇口人民医院骨科

出　　处：《中外医疗》2019年第21期95-97,共3页China & Foreign Medical Treatment

基　　金：深圳市科创委课题(JCYJ20150403093555019)

摘　　要：目的比较人工髋关节置换和空心钉内固定治疗高龄患者股骨颈骨折效果。方法方便选取该院于2016年6月-2018年6月收治的86例高龄股骨颈患者,对患者的临床资料进行回顾性分析,将采用人工髋关节置换的43例患者作为观察组,将采用空心钉内固定的43例患者作为对照组,对两组的手术相关资料、发症及术后髋关节Harris评分进行观察比较。结果观察组与对照组总发生率为4.66%、23.26%,差异有统计学意义(χ^2=6.198,P=0.013)观察组与对照组的手术时间分别为(84.26±6.28)min、(53.27±9.68)min,(t=17.612,P=0.000);术中出血量为(264.27±50.26)mL、(117.56±21.38)mL(t=17.614,P=0.000);术后下地时间为(15.18±4.02)d、(74.83±13.92)d,(t=26.997,P=0.00)差异有统计学意义(P<0.05)。结论采用人工髋关节置换治疗高龄股骨颈骨折具有术后并发症少,髋关节功能恢复良好等优点,但对于年龄偏大无法耐受手术及骨折位移较小的患者更适合空心钉内固定,临床上需要根据具体情况选择合适的手术方法。Objective To compare the effects of artificial hip replacement and cannulated screw fixation in the treatment of femoral neck fracture in elderly patients. Methods Eighty-six elderly patients with femoral neck who were admitted to our hospital from June 2016 to June 2018 were enrolled. The clinical data of the patients were retrospectively analyzed. 43 patients with artificial hip replacement were used as the observation group. Forty-three patients underwent internal fixation as a control group, and the surgical data, onset and postoperative hip Harris score of the two groups were compared. Results The total incidence of observation group and control group was 4.66%, 23.26%, the difference was statistically significant(χ^2=6.198, P=0.013). The operation time of observation group and control group were(84.26±6.28)min,(53.27±9.68) min,(t=17.612, P=0.000);intraoperative blood loss was(264.27±50.26)mL,(117.56±21.38) mL,(t=17.614, P=0.000);postoperative ground time was(15.18±4.02)d,(74.83±13.92)d,(t=26.997, P=0.00), the difference was statistically significant(P<0.05).Conclusion Artificial hip replacement for advanced age Femoral neck fracture has the advantages of less postoperative complications and good recovery of hip function. However, it is more suitable for patients with large age and intolerable surgery and small fracture displacement. It is necessary to choose appropriate surgical methods according to the specific situation.

关 键 词：人工髋关节置换术 空心钉内固定术 高龄患者 股骨颈骨折 

分 类 号：R7[医药卫生—临床医学]