全髋关节置换术与股骨近端髓内钉内固定术治疗不稳定型股骨转子间骨折患者的效果比较  

Comparison of effects of total hip arthroplasty and proximal femoral intramedullary nail internal fixation in the treatment of patients with unstable intertrochanteric fractures

作　　者：张良 ZHANG Liang(Department of Joint Surgery of Puyang People’s Hospital,Puyang 457001 Henan,China)

机构地区：[1]濮阳市人民医院关节外科,河南濮阳457001

出　　处：《中国民康医学》2024年第15期153-155,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:比较全髋关节置换术与股骨近端髓内钉内固定术治疗不稳定型股骨转子间骨折患者的效果。方法:选取2020年1月至2023年1月该院收治的210例不稳定型股骨转子间骨折患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各105例。对照组采用抗旋转型股骨近端髓内钉内固定术治疗,观察组采用全髋关节置换术治疗,比较两组围术期指标(手术时间、术后首次下床时间、住院时间、术中出血量)水平、髋关节功能评分量表(Harris)评分和并发症发生率。结果:观察组手术时间、术后首次下床时间、住院时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);术后3个月,两组Harris各维度评分高于术前,且观察组高于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为3.81%,明显低于对照组的12.38%,差异有统计学意义(P<0.05)。结论:全髋关节置换术治疗不稳定型股骨转子间骨折患者可提高髋关节功能评分,降低围术期指标水平及并发症发生率,效果优于抗旋转型股骨近端髓内钉内固定术治疗。Objective:To compare effects of total hip arthroplasty and proximal femoral intramedullary nail internal fixation in the treatment of patients with unstable intertrochanteric fractures.Methods:A prospective study was conducted on 210 patients with unstable intertrochanteric fractures admitted to this hospital from January 2020 to January 2023.According to the random number table method,they were divided into observation group and control group,105 cases in each group.The control group was treated with proximal femoral intramedullary nail anti-rotation internalfixation,while the observation group was treated with total hip arthroplasty.The perioperative indexes(operation time,first out-of-bed time after the surgery,hospitalization time,intraoperative blood loss)levels,the hip function score scale(Harris)score,and the incidence of complications were compared between the two groups.Results:The levels of perioperative indexes such as operation time,first out-of-bed time after the surgery,hospitalization time were shorter than those in the control group,and intraoperative blood loss in the observation group was less than that in the control group,and the differences were statistically significant(P<0.05).3 months after the surgery,the Harris scores of each dimension in the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 3.81%,which was significantly lower than 12.38%in the control group,the difference was statistically significant(P<0.05).Conclusions:Total hip arthroplasty for the patients with unstable intertrochanteric fractures can improve the hip function scores,shorten the perioperative index levels,and reduce the incidence of complications.Moreover,it is superior to proximal femoral nail anti-rotation internalfixation.

关 键 词：不稳定型股骨转子间骨折 全髋关节置换术 股骨近端髓内钉内固定术 髋关节功能 并发症 

分 类 号：R683.3[医药卫生—骨科学]