人工髋关节置换术治疗老年股骨粗隆间粉碎性骨折的临床研究  

Clinical Study of Artificial Hip Replacement in the Treatment of Intertrochanteric Comminuted Fracture of Femur

作　　者：杨敏捷[1] 杨永华[1] 卢良杰[2] 罗素梅 YANG Minjie;YANG Yonghua;LU Liangjie;LUO Sumei(Department of Orthopedics,Jiujiang NO.1 People's Hospital,Jiujiang 332000,China;不详)

机构地区：[1]九江市第一人民医院骨科,江西九江332000 [2]宁波市医疗中心李惠利医院骨科,浙江宁波315199 [3]九江市第一人民医院肿瘤科,江西九江332000

出　　处：《中国医学创新》2024年第28期40-44,共5页Medical Innovation of China

基　　金：宁波市自然科学基金重点项目(2023J032)。

摘　　要：目的:分析人工髋关节置换术对老年股骨粗隆间粉碎性骨折患者的影响。方法:选择2020年7月—2023年7月九江市第一人民医院收治的60例老年股骨粗隆间粉碎性骨折患者作为研究对象,随机分为对照组(内固定术)与观察组(人工髋关节置换术),各30例。比较两组手术指标及手术前后的髋关节评分、炎症因子水平、生活质量评分。结果:两组手术时间比较差异无统计学意义(P>0.05);观察组住院时间短于对照组,术后下床活动时间早于对照组,术中出血量少于对照组(P<0.05)。术前,两组Harris髋关节功能评分、炎症因子水平、健康调查简表(SF-36)评分比较差异均无统计学意义(P>0.05);术后4周,两组Harris髋关节功能评分、SF-36各项评分均高于术前,hs-CRP、IL-6、TNF-α均低于术前,且观察组Harris髋关节功能评分、SF-36各项评分均高于对照组,hs-CRP、IL-6、TNF-α均低于对照组(P<0.05)。结论:老年股骨粗隆间粉碎性骨折患者采用人工髋关节置换术治疗效果更好,降低机体炎症因子水平,提升髋关节功能及生活质量水平,综合应用价值更高。Objective:To analyze the effect of artificial hip replacement on elderly patients with intertrochanteric comminuted fracture of femur.Method:A total of 60 elderly patients with intertrochanteric comminuted fracture of femur treated in Jiujiang NO.1 People's Hospital from July 2020 to July 2023 were selected as the study objects and randomly divided into control group(internal fixation)and observation group(artificial hip replacement),with 30 cases in each group.The hip joint score,inflammatory factor level and quality of life score before and after surgery were compared between two groups.Result:There was no significant difference in surgery time between two groups(P>0.05).The length of hospital stay of the observation group was shorter than that of the control group,the time of getting out of bed after surgery was earlier than that of control group,and the amount of blood loss during surgery was less than that of control group(P<0.05).Before surgery,there were no significant differences in Harris hip function score,inflammatory factor level and the MOS item short from health survey(SF-36)score between two groups(P>0.05).Four weeks after surgery,Harris hip function score and SF-36 scores in both groups were higher than those before surgery,hs-CRP,IL-6 and TNF-αwere lower than those before surgery,and Harris hip function score and SF-36 scores in the observation group were higher than those in the control group,hs-CRP,IL-6 and TNF-αwere lower than those of control group(P<0.05).Conclusion:In elderly patients with intertrochanteric comminuted fracture of femur,artificial hip replacement has better treatment effect,reduces the level of inflammatory factors in the body,improves the hip function and quality of life,and has higher comprehensive application value.

关 键 词：人工髋关节置换术 老年 股骨粗隆间粉碎性骨折 髋关节评分 

分 类 号：R687.3[医药卫生—骨科学]