人工全髋关节置换术与动力髋螺钉内固定术治疗髋部骨折患者的效果比较  

Comparison of effects of total hip arthroplasty and dynamic hip screw internal fixation in treatment of patients with hip fractures

作　　者：臧随政[1] 雷联新[1] ZANG Suizheng;LEI Lianxin(Ward 2 of Department of Orthopedics of Lushan County People’s Hospital,Pingdingshan 467300 Henan,China)

机构地区：[1]鲁山县人民医院骨科二病区,河南平顶山467300

出　　处：《中国民康医学》2024年第21期141-144,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较人工全髋关节置换术与动力髋螺钉内固定术治疗髋部骨折患者的效果。方法:选取2020年1月至2023年1月该院收治的80例髋部骨折患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各40例。对照组采用动力髋螺钉内固定术治疗,研究组采用人工全髋关节置换术治疗,比较两组临床疗效、围术期指标水平,手术前后髋关节功能[Harris髋关节功能量表(HHS)]评分、日常活动能力[Barthel指数(BI)]评分、创伤应激指标[肾上腺素(E)、β-内啡肽(β-EP)、皮质醇(Cor)]水平、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]水平,以及并发症发生率。结果:研究组治疗总有效率为95.00%(38/40),高于对照组的77.50%(31/40),差异有统计学意义(P<0.05);研究组首次负重时间、骨折愈合时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后3个月,两组HHS、BI评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);术后7 d,两组E、β-EP、Cor水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);术后7 d,两组IL-1β、CRP、TNF-α水平均高于术前,但研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为10.00%(4/40),低于对照组的27.50%(11/40),差异有统计学意义(P<0.05)。结论:人工全髋关节置换术治疗髋部骨折患者可提高治疗总有效率、髋关节功能和日常生活能力评分,改善围术期指标水平,降低创伤应激指标水平、炎性因子水平和并发症发生率的效果优于动力髋螺钉内固定术治疗。Objective:To compare effects of total hip arthroplasty and dynamic hip screw internal fixation in treatment of patients with hip fractures.Methods:A prospective study was conducted on 80 patients with hip fractures admitted to the hospital from January 2020 to January 2023.According to the random number table method,they were divided into study group and control group,40 cases in each group.The control group was treated with dynamic hip screw internal fixation,while the study group was treated with total hip arthroplasty.The clinical efficacy,the perioperative index level,the hip joint function[Harris hip scale(HHS)]scores,the daily activity ability[Barthel index(BI)]score,the traumatic stress index[epinephrine(E),β-endorphin(β-EP),cortisol(Cor)]levels,the inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)]levels before and after the surgery,and the incidence of complications were compared between the two groups.Results:The total effective rate of treatment in the study group was 95.00%(38/40),which was higher than 77.50%(31/40)in the control group,and the difference was statistically significant(P<0.05).The first weight-bearing time,the fracture healing time and the hospitalization time of the study group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).Three months after the surgery,the scores of HHS and BI in the two groups were higher than those before the surgery,those in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Seven days after the surgery,the levels of E,β-EP and Cor in the two groups were higher than those before the surgery,but those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Seven days after the surgery,the levels of IL-1β,CRP and TNF-αin the two groups were higher than th

关 键 词：人工全髋关节置换术 动力髋螺钉内固定术 髋部骨折 关节功能 创伤应激 炎性因子 并发症 

分 类 号：R687.4[医药卫生—骨科学]