后路小切口髋关节置换术治疗股骨颈骨折疗效研究  

The curative effect of posterior small incision hip replacement for femoral neck fracture

作　　者：刘昌海[1] 俞思明[1] 王占朝[1] 陈庆运 LIU Chang-hai;YU Si-ming;WANG Zhan-chao;CHEN Qing-yun(Department of Orthopaedic,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院骨科,上海202150

出　　处：《创伤与急危重病医学》2020年第4期224-227,共4页Trauma and Critical Care Medicine

摘　　要：目的探讨后路小切口髋关节置换术治疗股骨颈骨折的疗效及其对血流动力学的影响。方法选取自2016年1月至2018年1月上海交通大学医学院附属新华医院崇明分院收治的100例股骨颈骨折患者为研究对象。根据手术方法将患者分为A组(n=49)与B组(n=51)。A组采用传统外侧小切口髋关节置换术治疗,B组采用后路小切口髋关节置换术治疗,比较两组治疗后的优良率,术中及术后患者的心率(HR)、收缩压(SBP)水平的变化情况,口述评分法(VRS)、视觉模拟疼痛评分(VAS)、髋关节功能评分(Harris)及并发症的发生情况。结果A组患者的优良率为81.6%(40/49),明显低于B组的96.0%(49/51),两组间比较,差异有统计学意义(P<0.05)。B组患者术中、术后HR水平均高于A组,SBP水平低于A组,差异均有统计学意义(P<0.05)。术后,两组患者的VRS、VAS评分均显著下降,Harris评分升高,且B组VRS、VAS评分低于A组,Harris评分高于A组,差异均有统计学意义(P<0.05)。A组患者的不良反应发生率为20.4%(10/49),明显高于B组的4.0%(2/51),两组间比较,差异有统计学意义(P<0.05)。结论后路小切口髋关节置换术治疗股骨颈骨折的效果较好,对患者血流动力学的影响较小。Objective To investigate the effect of posterior small incision hip replacement for femoral neck fracture and its effect on hemodynamics.Methods A retrospective study was performed on 100 cases of patients with femoral neck fracture who were admitted from January 2016 to January 2018.Patients were divided into Group A(n=49)and Group B(n=51)according to the surgical method.Group A of patients were treated with traditional lateral small incision hip replacement,while Group B of patients were treated with posterior small incision hip replacement.The excellent and good rates after treatment,the changes in heart rate(HR),systolic blood pressure(SBP),verbal rating scale(VRS),visual analogue scale(VAS),hip joint function score(Harris),and the incidence of complications were compared between the two groups.Results The excellent and good rate of Group A was 81.6%(40/49),which was significantly lower than that of Group B(96.0%,49/51),and the differences were statistically significant(P<0.05).The intraoperative and postoperative HR level of patients in Group B was higher than that of Group A,while the SBP level was lower than that of Group A(P<0.05).After surgery,VRS and VAS scores in both groups were significantly reduced,while Harris scores were increased,and VRS and VAS scores in Group B were lower than those in Group A,while Harris scores were higher than those in Group A(P<0.05).The incidence of adverse reactions in Group A was 20.4%(10/49),significantly higher than that in Group B(4.0%,2/51),and the differences were statistically significant(P<0.05).Conclusion Posterior small incision hip arthroplasty is effective in treating femoral neck fractures and has little effect on the patient′s hemodynamics.

关 键 词：后路小切口 髋关节置换术 股骨颈骨折 血流动力学 

分 类 号：R687.4[医药卫生—骨科学]