钢板内固定术与人工关节置换术在老年髋部骨折患者治疗中的效果对比分析  

Comparative Analysis of the Effect of Plate Internal Fixation and Artificial Joint Replacement in the Treatment of Elderly Patients with Hip Fracture

作　　者：闫志强[1] YAN Zhiqiang(Department of Orthopedics,Linyi Hospital of Traditional Chinese Medicine,Linyi 276000,China)

机构地区：[1]山东省临沂市中医医院骨科,山东临沂276000

出　　处：《中国伤残医学》2024年第21期13-17,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨在老年髋部骨折患者治疗中应用钢板内固定术与人工关节置换术的效果。方法:选择2022年5月—2024年1月临沂市中医医院收治的56例老年髋部骨折患者为研究对象,按随机数字表法将其分为对照组与研究组,各28例。对照组采用钢板内固定术治疗,研究组采用人工关节置换术治疗。两组术后均观察6个月。对比两组临床疗效、手术指标、髋关节功能、骨代谢指标及并发症发生情况。结果:研究组临床治疗总有效率为96.43%,高于对照组的71.43%,差异有统计学意义(P<0.05)。研究组手术时间、术后开始下床活动时间均短于对照组,术中出血量、术中输血量均低于对照组,差异均有统计学意义(P<0.05)。术后1、3、6个月,两组Harris髋关节功能量表评分均高于治疗前,且研究组均高于对照组,差异均有统计学意义(P<0.05)。术后6个月,两组纤维细胞生长因子-2、骨钙素水平均高于治疗前,且研究组均高于对照组,缺氧诱导因子-1α、组织非特异性碱性磷酸酶水平均低于治疗前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为7.14%,低于对照组的28.57%,差异有统计学意义(P<0.05)。结论:老年髋部骨折患者采用人工关节置换术治疗可缩短手术及术后首次下床活动时间,改善关节功能与骨代谢指标,提升治疗有效性,减少术后并发症发生情况。Objective:To investigate the effect of internal fixation and artificial joint replacement in the treatment of elderly patients with hip fracture.Methods:A total of 56 elderly patients with hip fracture admitted to Linyi Hospital of Traditional Chinese Medicine from May 2022 to January 2024 were selected as the study objects,and were divided into a control group and a study group according to random number table method,with 28 cases in each group.The control group was treated with internal fixation of steel plate,and the study group was treated with artificial joint replacement.Both groups were observed for 6 months after opeation.The clinical efficacy,surgical indexes,joint function indexes,bone metabolism indexes and complications were compared between the two groups.Results:The total effective rate of the study group was 96.43%,which was higher than 71.43%of the control group,the difference was statistically significant(P<0.05).The operation time,the time to get out of bed after operation in the study group were shorter than those in the control group,the amount of intraoperative blood loss and blood transfusion were lower than those of the control group,the differences were statistically significant(P<0.05).At 1 month,3 months and 6 months after surgery,the scores of Harris Hip Function Scale in both groups were higher than before treatment,and the study group was higher than the control group,with statistical significance(P<0.05).Six months after surgery,the levels of fibrocyte growth factor-2 and osteocalcin in both groups were higher than before treatment,and the study group were higher than the control group,the levels of hypoxic-induced-factor-1αand tissue non-specific alkaline phosphatase were lower than before treatment,and the study group were lower than the control group,with statistical significance(P<0.05).The incidence of complications in the study group was 7.14%,which was lower than 28.57%in the control group,and the difference was statistically significant(P<0.05).Conclusion:The use of artifici

关 键 词：髋部骨折 钢板内固定术 人工关节置换术 老年 出血量 并发症 下床活动时间 

分 类 号：R687.4[医药卫生—骨科学]