不同类型假体人工髋关节置换术在老年不稳定性股骨转子间骨折患者中的效果及其对假体周围BDM水平的影响  

Effects of different types of prostheses on the level of periprosthetic BDM in elderly patients with unstable intertrochanteric femoral fractures

作　　者：段冰川 梁艳伟 田芳芳 Duan Bing-chuan;Liang Yan-wei;Tian Fang-fang(Department of Orthopedics,Tangyin People's Hospital·The Eighth People's Hospital of Anyang,Anyang 456150,Henan,China)

机构地区：[1]汤阴县人民医院(安阳市第八人民医院)骨科,河南安阳456150

出　　处：《四川生理科学杂志》2023年第9期1614-1617,1670,共5页Sichuan Journal of Physiological Sciences

摘　　要：目的:探究不同类型假体在老年不稳定性股骨转子间骨折行人工髋关节置换术治疗中的应用效果及其对髋关节功能与股骨假体周围骨密度(Bone mineral density,BDM)水平的影响对比。方法:选取2020年7月到2022年2月期间我院我科收治的123例需接受人工髋关节置换术治疗的老年不稳定性股骨转子间骨折患者作为研究对象,随机分为骨水泥组(n=61)和生物型组(n=62)。骨水泥组安装骨水泥型臼杯,生物组采用生物型假体治疗,比较两组患者围手术指标、髋关节功能、股骨假体周围骨密度、假体稳定率及并发症发生率。结果:骨水泥组手术时间较生物型组长,术后引流量较生物型组少(P<0.05),术中出血量及下床活动时间两组间无明显差异(P>0.05);两组髋关节Harris评分量表疼痛、活动度、畸形及功能四个方面评分以及髋关节功能总分均较手术前上升,骨水泥组均低于生物型组(P<0.05);术后6m,两组患者Gruen 1区、Gruen 6区及Gruen 7区骨密度水平均较术后1w明显下降(P<0.05);其余各区与术后1w比较无明显差异(P>0.05);术后6m时两组间各区骨密度无明显差异(P>0.05);生物型组假体稳定率明显高于骨水泥组(P<0.05);两组总并发症发生率无明显差异(P>0.05)。结论:生物型假体在老年不稳定性股骨转子间骨折行人工髋关节置换术治疗中有利于缩短手术时间,能提升假体稳定性,有效促进髋关节功能恢复,且不增加骨丢失及骨水泥中毒等发生风险。Objective:To explore the application effects of different types of prostheses in the treatment of unstable intertrochanteric femoral fractures in elderly patients with artificial hip replacement and compare their effects on hip function and perifemoral bone mineral density(BDM).Methods:A total of 123 elderly patients with unstable intertrochanteric fracture of femur admitted to our hospital from July 2020 to February 2022 were selected and randomly divided into bone cement group(n=61)and biological group(n=62)by the method of number table.Both patients were treated with artificial hip arthroplasty.The bone cement group was treated with bone cement prosthesis and the biological group was treated with biological prosthesis.Perioperative indexes,hip function,perifemoral bone density,prosthesis stability and complication rate were compared between the two groups.Results:Compared with the biological group,the operative time of the bone cement group was longer than that of the biological group,and the postoperative drainage volume was less than that of the biological group(P<0.05).There wasno significantdifference in the intraoperative blood loss and the time of getting out of bed between the two groups(P>0.05).Pain,range of motion,deformity and function scores of the Harris hip scale and total hip function scores of the two groups were higher than those before surgery,and the bone cement group was lower than the biological group(P<0.05).Six months after operation,bone mineraldensity in Gruen 1 zone,Gruen 6 zone and Gruen 7 zone of both groups was decreased compared with 1 week after surgery(P<0.05),but there was no significantdifference between the other zones,and there was no significantdifference between the two groups(P>0.05).The prosthesis stabilization rate of bone cement group waslower than that of biological type group(P<0.05).There was nosignificantsignificance in total complication rate betweenbothgroups(P>0.05).Conclusion:Biological prosthesis is beneficial to shorten the operative time,improve the stability

关 键 词：骨水泥型假体 生物型假体 人工髋关节置换术 骨密度 股骨转子间骨折 

分 类 号：R687.3[医药卫生—骨科学]