人工关节置换手术对老年创伤性髋部骨折患者的疗效及VAS评分的影响  

Surgical Effects and VAS Scores of Elderly Traumatic Hip Fracture Patients by Using Artificial Joint Replacement

作　　者：马存义[1] 吴少泉[1] 吴雪挺[1] 方胜 MA Cunyi;WU Shaoquan;WU Xueting;FANG Sheng(Guilin Hospital of Traditional Chinese Medicine,Guilin 541002,China;不详)

机构地区：[1]桂林市中医医院,广西桂林541002

出　　处：《中外医学研究》2022年第16期18-22,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研项目(z2016010)。

摘　　要：目的:探讨人工关节置换手术对老年创伤性髋部骨折患者的疗效及VAS评分的影响。方法:以桂林市中医医院2018年5月-2019年5月102例老年创伤性髋部骨折患者为此次研究主体,根据手术方法的不同分为置换组和内固定组,各51例,分别行人工关节置换手术与骨折内固定,对比两组手术相关指标、术后并发症、术后不同时间疼痛程度及髋关节功能恢复情况。结果:两组手术耗时比较,差异无统计学意义(P>0.05),置换组患者的术后下床活动时间、部分负重时间及术后住院时间均优于内固定组,术中出血量少于内固定组,差异有统计学意义(P<0.05)。置换组并发症发生率为3.92%,低于内固定组的17.65%,差异有统计学意义(P<0.05)。术前,两组的视觉模拟疼痛评分量表(visual analogue scale,VAS)评分比较,差异无统计学意义(P>0.05),术后6、24、72 h,置换组VAS评分水平明显低于内固定组,差异有统计学意义(P<0.05);置换组术后6、12个月的Harris评分高于内固定组,且置换组髋关节功能恢复优良率高于内固定组,差异有统计学意义(P<0.05)。结论:采用人工关节置换手术对老年创伤性髋部骨折患者的近期疗效更优,可有效降低其术后疼痛及不适,缩短卧床恢复时间,促进病情康复。Objective:To discuss the surgical effects and visual analogue scale(VAS)scores of elderly traumatic hip fracture patients using artificial joint replacement.Method:A total of 102 elderly patients with traumatic hip fracture treated from May 2018to May 2019 in Guilin Hospital of Traditional Chinese Medicine were selected and divided into replacement group and fixation group according to different schemes,51 cases in each group,the patients were respectively treated with artificial joint replacement or internal fixation.Surgical indicators,postoperative complications,pain degree at different period and hip joint function recovery conditions were compared.Result:There was no significant difference in operation time between the two groups(P>0.05),ambulant time,partial weightbearing time and hospitalization time in replacement group were better than those of fixation group,intraoperative bleeding volume was less than that of fixation group(P<0.05).Complication rate in replacement group(3.92%)was lower than that in fixation group(17.65%),the difference was statistically significant(P<0.05).Before surgery,the VAS score between the two groups were not statistically significantly different(P>0.05);after 6 h,24 h and 72 h of surgery,VAS scores in replacement group were significantly lower than those in fixation group(P<0.05).The Harris scores of the replacement group were higher than those of the internal fixation group at 6 and 12months after surgery,and the excellent and good rates of functional recovery of the hip joint in the replacement group were higher than those of the fixation group,the differences were statistically significant(P<0.05).Conclusion:For elderly traumatic hip fracture patients,the artificial joint replacement can better increase the short-term effects,reduce the postoperative pain and discomforts,shorten the hospitalization time and promote the fast recovery.

关 键 词：人工关节置换手术 老年 创伤性 髋部骨折 疼痛 

分 类 号：R687.3[医药卫生—骨科学]