牵引床辅助直接前侧入路股骨头置换术治疗老年股骨颈骨折的疗效  

Efficacy and safety offemoral head replacement through the direct anterior approach assisting by the traction tablefor femoral neck fracture in the elderly

作　　者：李骏然 梁卫东[1] 翟婧秀 梁俊生[1] 李力更[2] LI Junran;LIANG Weidong;ZHAI Jingxiu;LIANG Junsheng;LI Ligeng(不详;Department of Geriatric Orthopedics,the Second Hospital of Tangshan,Tangshan 063000,China)

机构地区：[1]唐山市第二医院老年骨科,河北唐山063000 [2]唐山市第二医院创伤外科研究所,河北唐山063000

出　　处：《实用医学杂志》2023年第24期3222-3226,共5页The Journal of Practical Medicine

基　　金：河北省医学科学研究课题计划(编号:20221741)。

摘　　要：目的分析应用牵引床辅助直接前侧入路(direct anterior approach,DAA)股骨头置换(femoral head replacement,FHR)治疗老年股骨颈骨折患者的临床疗效和安全性。方法回顾性分析2019年3月至2020年7月采用FHR治疗的79例老年股骨颈骨折患者的临床资料。其中,42例采用牵引床DAA-FHR(观察组),37例采用后外侧入路(posterolateral approach,PLA)(对照组)。比较两组围手术期、随访结果以及并发症发生情况。结果观察组术中出血量明显少于对照组(P<0.05),观察组术前准备时间明显长于对照组(P<0.05)。在麻醉时间和手术时间方面,两组差异无统计学意义(P>0.05)。观察组术后初次下床站立时间、部分负重行走时间和完全负重行走时间均明显早于对照组(P<0.05)。观察组术后1个月Harris评分明显优于对照组,差异有统计学意义(P<0.05),但两组的术后6个月、术后1年Harris评分以及并发症发生率,差异无统计学意义(P>0.05)。结论牵引床辅助直接前侧入路股骨头置换术治疗老年股骨颈骨折早期临床疗效与安全性值得肯定,但术前准备时间较长。Objective To analyze the clinical efficacy and safety off emoral head replacement(FHR)assisting by the traction table in direct anterior approach(DAA)for the treatment of femur neck fractures in gerontal patients.Methods A retrospective analysis was conducted on 79 elderly patients who under went FHR for femoral neck fractures from March 2019 to July 2020.A total of 42 patients underwent FHR through DAA by using traction table were assigned to the observation group and 37 patients receiving FHR through the PLA to the control group.The perioperative data,follow-up results and complications were compared between the two groups.Results The observation group was significantly superior to the control group in intraoperative blood loss(P<0.05),where as the former was inferior to the latter in preoperative preparation time(P<0.05).There was no significant difference in anesthesia time and operation time between the two groups(P>0.05).The observation group resumed first postoperative standing time,partial-weight bearing walking time and full-weight bearing walk-ing time significantly earlier than control group(P<0.05).Harris score at 1 month after the operation in the observation group were significantly higher than that of the control group(P<0.05),whereas which became not statistical significant between the two groups in 6 months and 1 year(P>0.05).No significant difference was found between the two groups for the incidence of complications(P>0.05).Conclusion DAA-FHR assisting by the traction table for the treatment of femur neck fractures in the elderly was effective and safe,but the preoperative preparation time was longer.

关 键 词：直接前入路 牵引床 股骨颈骨折 高龄 股骨头置换术 

分 类 号：R683.42[医药卫生—骨科学]