全髋关节置换与内固定术治疗老年股骨颈骨折术后髋关节功能及免疫炎性反应比较  

Comparison of hip function and immunoinflammatory response after total hip replacement and internal fixation in elderly patients with femoral neck fracture

作　　者：刘懋 周广福 LIU Mao;ZHOU Guang-Fu(Department of Joint Surgery,Guizhou Hospital,Beijing Jishuitan Hospital,Guizhou 550014,Guiyang,China)

机构地区：[1]北京积水潭医院贵州医院关节外科,贵州贵阳550014

出　　处：《吉林医学》2025年第2期314-317,共4页Jilin Medical Journal

基　　金：贵州省普通高等学校科技拔尖人才项目[项目编号:黔教合KY字[2021]033]。

摘　　要：目的:探讨全髋关节置换术与内固定术治疗老年股骨颈骨折术后髋关节功能、免疫炎性反应对比。方法:选取2020年1月~2023年11月北京积水潭医院贵州医院收治的154例老年股骨颈骨折患者为观察对象,按照手术方法分为对照组72例、观察组82例,对照组采取内固定术,观察组采取全髋关节置换术,比较手术期指征、手术前、后髋关节功能(Harris评分)、疼痛视觉模拟评分(VAS评分)、生活质量评分、术后并发症发生率、免疫炎性反应水平。结果:术后住院时间观察组低于对照组,手术时间、出血量观察组高于对照组,差异有统计学意义(P<0.05)。术后1个月两组髋关节功能Harris评分差异无统计学意义(P>0.05),术后6个月髋关节功能Harris评分观察组高于对照组,差异有统计学意义(P<0.05)。术前两组患者的疼痛评分差异无统计学意义(P>0.05),术后6个月观察组疼痛评分低于对照组,差异有统计学意义(P<0.05)。术前两组患者生活质量评分差异无统计学意义(P>0.05),术后6个月观察组高于对照组,差异有统计学意义(P<0.05)。术后观察组并发症发生率(2.44%)低于对照组(12.50%),差异有统计学意义(P<0.05)。免疫炎性反应指标整体呈先升高再降低趋势,组间、时点间差异有统计学意义(P<0.05)。结论:全髋关节置换术治疗老年股骨颈骨折对比内固定术,术后住院时间短,免疫炎性反应小,可更好改善患者髋关节功能、生活质量,降低疼痛、并发症发生率。Objective To compare the hip function and immunoinflammatory response after total hip replacement and internal fixation for elderly patients with femoral neck fracture.Method 154 elderly patients with femoral neck fracture admitted to Guizhou Hospital of Beijing Jishuitan Hospital from January 2020 to November 2023 were selected as the observation objects.The patients were divided into control group(72 cases)and observation group(82 cases).The control group underwent internal fixation and the observation group underwent total hip replacement.The indications of operative period,preoperative and postoperative hip function(Harris score),pain score(VAS score),quality of life score,postoperative complication rate,and immune inflammation level were compared.Results The hospitalization time in the observation group was lower than that in the control group.The operation time and blood loss in observation group were higher than those in control group(P<0.05).The Harris score of hip function showed no statistically significant difference between the two groups before surgery(P>0.05),while the Harris score of hip function in the observation group was higher after surgery(P<0.05).There was no significant difference in preoperative pain score between the two groups(P>0.05),and postoperative pain score in the observation group was lower than that in the control group(P<0.05).The quality of life score of the two groups before surgery was compared(P>0.05),and the score of the observation group was higher than that of the control group after surgery(P<0.05).The complication rate of observation group(2.44%)was lower than that of control group(12.50%)(P<0.05).The overall immunoinflammatory indexes showed a trend of first increasing and then decreasing,and the differences among groups,time points,and time points were statistically significant(P<0.05).Conclusion Compared with internal fixation,total hip replacement in the treatment of femoral neck fracture in elderly patients has shorter hospital stay and less immune inflammatory res

关 键 词：全髋关节置换术 内固定术 老年股骨颈骨折 髋关节功能 免疫炎性反应 

分 类 号：R683.42[医药卫生—骨科学]