人工髋关节置换术在老年髋关节骨折内固定失败患者中的应用效果观察  

Clinical observation of artificial hip replacement in elderly hip fracture patients with internal fixation failure

作　　者：孙景波 SUN Jingbo(Department of Orthopedics,Chengwu County People’s Hospital,Heze,Shandong 274200,China)

机构地区：[1]成武县人民医院骨科,山东菏泽274200

出　　处：《医药前沿》2022年第31期19-21,共3页Journal of Frontiers of Medicine

摘　　要：目的:观察人工髋关节置换术在老年髋关节骨折内固定失败患者中的应用效果。方法:选取2018年2月—2022年1月成武县人民医院骨科收治的90例老年髋关节骨折内固定失败患者。所有患者均应用人工髋关节置换术治疗,分析患者的手术指标(手术时间、出血量)、并发症发生情况(切口感染、神经血管损伤、假体破裂、假体脱位或松动、下肢静脉血栓)。分析治疗前、后的疼痛程度(VAS评分)、髋关节功能(Harris评分)、屈髋活动度、生活质量(SF-36评分)以及临床疗效。结果:90例患者的平均手术时间为(120.46±29.34)min,平均出血量为(426.17±81.80)mL。、发生切口感染2例,神经血管损伤1例,假体脱位或松动1例,无假体破裂、下肢静脉血栓病例,并发症总发生率为4.44%。两组患者均随访6个月,治疗后,患者的VAS评分、Harris评分、屈髋活动度以及SF-36评分均明显优于治疗前,差异有统计学意义(P<0.05)。临床疗效评估中,优29例,良47例,可12例,差2例,优良率为84.44%。结论:人工髋关节置换术、在老年髋关节骨折内固定失败患者中的应用效果较好,具有手术时间短、出血量少的特点,且并发症发生率较低,能够明显减轻患者疼痛症状,有助于髋关节功能的恢复,治疗后屈髋活动度大,患者生活质量显著提升,值得临床应用。Objective To investigate the application effect of artificial hip replacement in the treatment of internal fixation failure of elderly hip fractures.Methods A total of 90 elderly patients with failed internal fixation of hip fracture admitted to the Department of Orthopedics of Chengwu County People’s Hospital from February 2018 to January 2022 were enrolled.All patients were treated with artificial hip replacement,and the patient’s surgical indicators(operation time,amount of bleeding)and complications(incision infection,neurovascular injury,prosthesis rupture,prosthesis dislocation or loosening,lower extremity venous thrombosis)were analyzed.Pain degree before and after treatment(VAS score),hip function(Harris score),hip flexion range,quality of life(SF-36 score),and clinical efficacy were analyzed.Results The average operation time of 90 patients was(120.46±29.34)min,and the average blood loss was(426.17±81.80)mL.There were 2 cases of incision infection,1 case of neurovascular injury,1 case of prosthesis dislocation or loosening,no prosthesis rupture and lower extremity venous thrombosis,and the total complication rate was 4.44%.Both groups were followed for 6 months,and after treatment,the VAS score,Harris score,hip flexion range and SF-36 score were significantly better than those before treatment,and the differences were statistically significant(P<0.05).In the evaluation of clinical efficacy,29 cases were excellent,47 cases were good,12 cases were medium,2 cases were poor,and the excellent rate was 84.44%.Conclusion The application effect of artificial hip replacement in the failure of internal fixation of elderly hip fractures is good,with the characteristics of short operation time,low bleeding,and low complication rate,which can significantly reduce the pain symptoms of patients,help the recovery of hip joint function,and have a large range of hip flexion after treatment,and the quality of life of patients is significantly improved,which is worthy of clinical promotion and application.

关 键 词：老年髋关节骨折 人工髋关节置换术 屈髋活动度 

分 类 号：R683[医药卫生—骨科学]