不同置换术治疗高龄股骨颈骨折的临床研究  

Clinical study on different replacement in treatment of femoral neck fractures in elderly patients

作　　者：罗焕明[1] 谭志伟[1] 徐攀东 LUO Huanming;TAN Zhiwei;XU Pandong(The Sixth People’s Hospital of Nanhai District,Foshan 528200,China)

机构地区：[1]广东省佛山市南海区第六人民医院

出　　处：《中国医药科学》2019年第22期254-256,共3页China Medicine And Pharmacy

摘　　要：目的探究高龄股骨颈骨折患者行全髋关节置换术和双极股骨头置换术治疗的效果差异。方法择取2017年2月~2018年2月我院收治的38例高龄股骨颈骨折患者为研究对象,根据患者入院时间先后顺序为依据将其分为对照组与观察组,每组19例。对照组患者行全髋关节生物型假体置换术治疗,观察组患者行双极股骨头置换术治疗,对两组患者围术期指标、治疗后Harris髋关节功能恢复情况以及并发症发生率进行比较。结果观察组患者手术时间、出血量、术后引流量、骨折愈合时间及住院时间相比对照组更少,差异有统计学意义(P<0.05);观察组患者术后6个月Harris髋关节功能评分低于对照组,且并发症发生率显著高于对照组,差异有统计学意义(P<0.05)。结论两种手术方式对高龄股骨颈骨折患者均具有良好的短期疗效,但是全髋关节置换术远期并发症风险低,髋关节功能恢复更理想,而人工双极股骨头置换术创伤小,住院时间短,因此可根据患者实际情况选择合适的手术疗法。Objective To explore the differences in curative effects of total hip arthroplasty and bipolar femoral head replacement in treatment of elderly patients with femoral neck fractures.Methods Thirty-eight elderly patients with femoral neck fractures who were admitted and treated in our hospital from February 2017 to February 2018 were selected as research objects.They were divided into the control group and the observation group according to the order of admission,with 19 cases in each group.Patients in the control group underwent total hip arthroplasty with bioprosthesis while patients in the observation group underwent bipolar femoral head replacement.The perioperative indexes,Harris hip function recovery and complication rate after treatment were compared between the two groups.Results The operation time,blood loss,postoperative drainage,fracture healing time and hospital stay in the observation group were significantly less than those in the control group.The difference was statistically significant(P<0.05).The Harris hip function score of the observation group was lower than that of the control group in 6 months after surgery and complication rate was significantly higher than that in the control group.The difference was statistically significant(P<0.05).Conclusion Both surgical procedures have good short-term curative effects in treatment of elderly patients with femoral neck fractures,but total hip arthroplasty has low risk of long-term complications and more ideal hip function recovery.But artificial bipolar femoral head replacement has less trauma and shorter hospital stay.Therefore,appropriate surgical therapy can be selected according to the actual situation of patients.

关 键 词：全髋关节生物型假体置换术 双极股骨头置换术 高龄患者 股骨颈骨折 髋关节功能 

分 类 号：R683.42[医药卫生—骨科学]