人工全髋关节置换术与人工股骨头置换术治疗老年移位股骨颈骨折的近远期疗效  

Short-term and long-term effects of total hip replacement and femoral head replacement in the treatment of displaced femoral neck fractures in elderly patients

作　　者：王立山 WANG Lishan(Department of Orthopaedic Surgery,Liaoyang Central Hospital,Liaoyang,Liaoning,111000,China)

机构地区：[1]辽阳市中心医院骨外科,辽宁辽阳111000

出　　处：《当代医学》2022年第35期52-56,共5页Contemporary Medicine

摘　　要：目的探究人工全髋关节置换术与人工股骨头置换术治疗老年移位股骨颈骨折的近远期疗效。方法选取2018年1月至2019年3月本院收治的62例老年移位型股骨颈骨折患者作为研究对象,按照随机数字表法分为全髋关节组与股骨头组,每组31例。全髋关节组采用人工全髋关节置换术治疗,股骨头组采用人工股骨头置换术治疗,比较两组手术指标(术中失血量、手术时间、早期下床时间、住院时间)、痛程程度[视觉模拟评分法(VAS)]、舒适度[布氏舒适量表(BCS)]、血清炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)]及髋关节功能(Harris评分、优良率)。结果两组住院时间比较差异无统计学意义;股骨头组术中失血量少于全髋关节组,手术时间、早期下床时间均短于全髋关节组,差异有统计学意义(P<0.05)。两组VAS、BCS评分组间、时间、交互比较差异有统计学意义(P<0.05);术后1 d、5 d,两组VAS评分均低于术前,BCS评分均高于术前,且股骨头组VAS评分低于全髋关节组,BCS评分高于全髋关节组,差异有统计学意义(P<0.05);术后5 d,两组VAS评分均高于术后1 d,BCS评分均低于术后1 d,差异有统计学意义(P<0.05)。两组WBC、CRP水平组间、时间、交互比较差异有统计学意义(P<0.05);术后1、5 d,两组WBC、CRP水平均高于术前,但股骨头组低于全髋关节组,差异有统计学意义(P<0.05);术后5 d,两组WBC、CRP水平均低于术后1 d,差异有统计学意义(P<0.05)。术后随访24个月,股骨头组Harris评分低于全髋关节组,差异有统计学意义(P<0.05)。两组优良率比较差异无统计学意义。结论人工全髋关节置换术与人工股骨头置换术治疗老年移位型股骨颈骨折各有优势,人工股骨头置换术创伤小,术后疼痛感较轻,舒适度较好,早期炎症反应轻,但人工全髋关节置换术远期髋关节功能恢复较好。Objective To explore the short-term and long-term effects of total hip replacement and femoral head replacement in the treatment of displaced femoral neck fractures in elderly patients.Methods 62 elderly patients with displaced femoral neck fracture admitted to our hospital from January 2018 to March 2019 were selected as the research subjects,and they were divided into total hip joint group and femoral head group according to random number table method,with 31 cases in each group.The total hip joint group was treated with total hip replacement,and the femoral head group was treated with femoral head replacement replacement,the surgical indexes(surgical blood loss,surgical time,early time of getting out of bed,length of hospital stay),pain duration(visual analogue scale[VAS]),comfort level(Bruggrmann comfort scale[BCS]),serum inflammatory indexes(white blood cell[WBC],C-reactive protein[CRP])and hip function(Harris score,excellent and good rate)were compared between the two groups.Results There was no significant difference in the length of hospital stay between the two groups;the surgical blood loss in the femoral head group was less than that in the total hip joint group,and the surgical time,early time of getting out of bed were shorter than those in the total hip joint group,the differences were statistically significant(P<0.05).There were statistically significant differences in VAS and BCS scores between the two groups of group,time poins and interaction(P<0.05);at 1 and 5 d after operation,the VAS scores of the two groups was lower than that before operation,and the BCS scores was higher than that before operation,and the VAS scores in the femoral head group were significantly lower than those in the total hip joint group,and the BCS scores was significantly higher than that in the total hip joint group,the differences were statistically significant(P<0.05);at 5 d after operation,the VAS scores of the two groups were higher than those at 1 d after operation,and the BCS scores were lower than those at 1 d a

关 键 词：股骨颈骨折 人工全髋关节置换术 人工股骨头置换术 关节功能 

分 类 号：R687.4[医药卫生—骨科学]