改良后路小切口髋关节置换术对老年股骨颈骨折患者髋关节功能及术后PINP、BAP、BGP水平的影响  

Effect of modified posterior small incision hip replacement on hip function and postoperative PINP,BAP,BGP in elderly patients with femoral neck fracture.

作　　者：詹云佳 金侠[1] 王雪飞[1] 龙安华[1] 张亚奎[1] ZHAN Yun-jia;JIN Xia;WANG Xue-fei(Department of Orthopedics,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101100,China.)

机构地区：[1]首都医科大学附属北京潞河医院骨科,北京101100

出　　处：《临床和实验医学杂志》2022年第3期320-324,共5页Journal of Clinical and Experimental Medicine

基　　金：首都卫生发展科研专项项目(编号:首发2020-2-7081)。

摘　　要：目的探究改良后路小切口髋关节置换术对老年股骨颈骨折患者髋关节功能及术后Ⅰ型前胶原氨基端前肽(PINP)、骨钙素(BGP)、骨特异性磷酸酶(BAP)的影响。方法回顾性选取2018年1月至2019年12月首都医科大学附属北京潞河医院收治的110例老年股骨颈骨折行髋关节置换术的患者为研究对象。按照采取的置换术入路方式不同分为髋关节前入路组(对照组)和改良小切口入路组(观察组),每组各55例。观察比较两组患者围手术期指标,术前术后Harris评分变化及血清PINP、BGP、BAP含量水平变化情况,两组治疗优良率、并发症等指标。结果观察组患者的切口长度、手术时间、术中出血量、术后1 d VAS评分、术后下地时间分别为(13.08±1.26)cm、(99.43±15.48)min、(162.59±25.29)mL、(4.48±1.04)分、(1.93±0.69)d,均低于对照组[(15.42±1.38)cm、(101.39±14.44)min、(173.84±25.29)mL、(6.42±1.04)分、(2.73±0.64)d],差异均有统计学意义(P<0.05)。术后1个月观察组患者PINP、BAP、BGP含量水平分别为(1024.39±89.21)pg/L、(40.87±4.92)ng/mL,(9.77±1.42)ng/mL,高于对照组患者[(848.72±53.46)pg/L、(33.54±4.76)ng/mL,(8.58±1.03)ng/mL],差异均有统计学意义(P<0.05)。术后1、6个月,观察组患者Harris评分分别为(79.76±6.36)、(85.46±7.03)分,高于对照组[(71.27±8.93)、(79.68±7.92)分],差异均有统计学意义(P<0.05)。观察组患者治疗优良率为90.91%,高于对照组的76.36%,观察组并发症率为5.45%,低于对照组的12.73%,差异均有统计学意义(P<0.05)。结论改良后路小切口髋关节置换术对老年股骨颈骨折患者髋关节功能恢复更快,能更好地改善围手术期不良指标,减少并发症发生,并提高骨代谢相关因子表达水平,有利于患者恢复。Objective To investigate the effects of modified posterior mini-incision hip arthroplasty on hip function and postoperative typeⅠprocollagen amino-terminal propeptide(PINP),osteocalcin(BGP)and bone specific phosphatase(BAP)in elderly patients with femoral neck fracture.Methods A toal of 110 elderly patients with femoral neck fractures who underwent hip replacement and were admitted to Beijing Luhe Hospital,Capital Medical University from January 2018 to December 2019 were retrospectively selected as research subjects.According to the different approaches of replacement surgery,they were divided into anterior hip approach group(control group)and modified small incision approach group(observation group),with 55 cases in each group.Perioperative indicators,preoperative and postoperative Harris score changes,serum PINP,BGP,BAP content changes,excellent treatment rate,complications and other indicators of the two groups were observed and compared.Results The incision length,operation time,intraoperative blood loss,1 d after surgery VAS score and postoperative ground time in the observation group were(13.08±1.26)cm,(99.43±15.48)min,(162.59±25.29)mL,(4.48±1.04)points,(1.93±0.69)d,respectively,which were lower than those in the control group[(15.42±1.38)cm,(101.39±14.44)min,(173.84±25.29)mL,(6.42±1.04)points,(2.73±0.64)d],the differences were statistically significant(P<0.05).One month after surgery,the levels of PINP,BAP and BGP in observation group were(1024.39±89.21)pg/L and(40.87±4.92)ng/mL,(9.77±1.42)ng/mL,respectively,which were higher than those in the control group[(848.72±53.46)pg/L,(33.54±4.76)ng/mL,(8.58±1.03)ng/mL],the differences were statistically significant(P<0.05).The Harris scores of observation group at 1 month and 6 months after operation were(79.76±6.36)and(85.46±7.03)points,which were higher than those of control group[(71.27±8.93)and(79.68±7.92)points],the differences were statistically significant(P<0.05).The excellent and good rate of the observation group was 90.91%,which w

关 键 词：髋关节置换 改良后路入路 骨代谢 髋关节功能 围手术期 

分 类 号：R687.4[医药卫生—骨科学]