全髋关节置换术与半髋关节置换术治疗股骨颈骨折的临床疗效  

Clinical efficacy of total hip arthroplasty and hemiarthroplasty in the treatment of femoral neck fracture

作　　者：高乐才[1] 左建刚[1] 李付彬[1] 马超[1] GAO Lecai;ZUO Jiangang;LI Fubin;MA Chao(Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei,061000,China)

机构地区：[1]沧州中西医结合医院,河北沧州061000

出　　处：《当代医学》2022年第36期49-52,共4页Contemporary Medicine

摘　　要：目的探讨全髋关节置换术与半髋关节置换术治疗股骨颈骨折的临床疗效。方法选取2019年1月至2020年6月本院收治的80例股骨颈骨折患者作为研究对象,按随机数字表法分为全髋组与半髋组,每组40例。全髋组给予全髋关节置换术,半髋组给予半髋关节置换术,比较两组白细胞介素-1(IL-1)、5-羟色胺(5-HT)、前列腺素E_(2)(PGE_(2))、皮质醇(Cor)、促肾上腺皮质激素(ACTH)及手术时间、手术出血量、下床活动时间、术后髋关节恢复时间、Harris评分、并发症发生情况。结果治疗后,两组IL-1、5-HT、PGE_(2)水平均低于治疗前,且全髋组低于半髋组,差异有统计学意义(P<0.05)。治疗后,两组Cor、ACTH水平均高于治疗前,但全髋组低于半髋组,差异有统计学意义(P<0.05)。全髋组手术时间、下床活动时间、术后髋关节恢复时间均长于半髋组,手术出血量多于半髋组,差异有统计学意义(P<0.05)。全髋组髋关节疼痛评分低于半髋组,髋关节功能、髋关节活动范围评分均高于半髋组,差异有统计学意义(P<0.05)。全髋组并发症发生率为5.00%,低于半髋组的25.00%,差异有统计学意义(P<0.05)。结论全髋关节置换术与半髋关节置换术均可治疗股骨颈骨折,两种手术方式各有利弊,临床中可根据患者具体情况合适术式。Objective To investigate the clinical efficacy of total hip arthroplasty and hemiarthroplasty in the treatment of femoral neck fractures.Methods 80 patients with femoral neck fracture treated in our hospital from January 2019 to June 2020 were selected as the research subjects,they were divided into the total hip group and the semi-hip group according to the random number table method,with 40 cases in each group.The levels of interleukin-1(IL-1),5-hydroxytryptamine(5-HT),prostaglandin E_(2)(PGE_(2)),cortisol(Cor),adrenocorticotropic hormone(ACTH),operation time,intraoperative blood loss,ambulation time,postoperative hip joint recovery time,Harris score,and complications were compared between the two groups.Results After treatment,the levels of IL-1,5-HT and PGE_(2) of the two groups were lower than those before treatment,and those in the total hip group were lower than those in the semi-hip group,and the differences were statistically significant(P<0.05).After treatment,the levels of Cor and ACTH of the two groups were higher than those before treatment,and those in the total hip group were lower than those in the semi-hip group,and the differences were statistically significant(P<0.05).The operation time,ambulation time,postoperative hip recovery time of the total hip group were longer than those of the semi-hip group,and the intraoperative blood loss of the total hip group was more than that of the semi-hip group,the difference was statistically significant(P<0.05).The incidence of complications in the total hip group was 5.00%,lower than that in 25.00%semi-hip group,and the difference was statistically significant(P<0.05).Conclusion Both total hip arthroplasty and hemiarthroplasty can treat femoral neck fractures,and the two surgical methods have their own advantages and disadvantages,in clinical practice,the appropriate surgical method can be selected according to the specific conditions of the patient.

关 键 词：股骨颈骨折 半髋关节置换术 全关节置换术 

分 类 号：R687.4[医药卫生—骨科学]