全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折患者的效果比较  

Comparison of effects of total hip arthroplasty and artificial femoral head replacement in treatment of elderly patients with femoral neck fractures

作　　者：李金光 任山 李传东 黄向业 于赋斌 李伟 张磊 LI Jinguang;REN Shan;LI Chuandong;HUANG Xiangye;YU Fubin;LI Wei;ZHANG Lei(Department of Orthopedics of Ji’nan Zhangqiu District People’s Hospital,Ji’nan 250200 Shandong,China)

机构地区：[1]济南市章丘区人民医院骨关节科,山东济南250200

出　　处：《中国民康医学》2025年第5期139-141,145,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较全髋关节置换术(THA)与人工股骨头置换术(AFHR)治疗老年股骨颈骨折患者的效果。方法:选取2019年1月至2024年1月该院收治的60例老年股骨颈骨折患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各30例。对照组采用AFHR治疗,观察组采用THA治疗。比较两组围手术期指标(术中出血量、手术时间、术后首次下床时间、住院时间)水平,手术前后髋关节功能[Harris髋关节评分系统(HHS)]评分、炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、降钙素原(PCT)、C反应蛋白(CRP)]水平,以及并发症发生率。结果:观察组术中出血量多于对照组,手术时间、术后首次下床时间、住院时间均长于对照组,差异有统计学意义(P<0.05);术后3、6个月,两组HHS评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后1个月,两组IL-8、IL-6、PCT、CRP水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为6.67%(2/30),低于对照组的26.67%(8/30),差异有统计学意义(P<0.05)。结论:THA治疗老年股骨颈骨折患者可提高髋关节功能评分,降低炎性因子水平和并发症发生率,效果优于AFHR,但会延长手术时间、术后首次下床时间、住院时间和增加术中出血量。Objective:To compare effects of total hip arthroplasty(THA) and artificial femoral head replacement(AFHR) in treatment of elderly patients with femoral neck fractures.Methods:A prospective study was conducted on 60 elderly patients with femoral neck fractures admitted to the hospital from January 2019 to January 2024.According to the random number table method,they were divided into control group and observation group,30 cases in each group.The control group was treated with AFHR,while the observation group was treated with THA.The levels of perioperative related indexes(intraoperative blood loss,operation time,first postoperative out-of-bed time,hospitalization time) levels,the hip function [Harris hip score system(HHS)] score,the inflammatory factors [interleukin-6(IL-6),interleukin-8(IL-8),procalcitonin(PCT),C-reactive protein(CRP)] levels before and after the surgery,and the incidence of complications were compared between the two groups.Results:The intraoperative blood loss in the observation group was more than that in the control group,the operation time and the first postoperative out-ofbed time and the hospitalization time were longer than those in the control group,and the differences were statistically significant(P<0.05).At 3 and 6 months,the HHS scores of 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).At 1 month after the surgery,the levels of IL-8,IL-6,PCT and CRP in the two groups were lower than those before the surgery,those in the observation group were lower 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 6.67%(2/30),which was lower than 26.67%(8/30) in the control group,and the difference was statistically significant(P<0.05).Conclusions:THA in the treatment of the elderly patients with femoral neck fractures can improve the hip function score

关 键 词：全髋关节置换术 人工股骨头置换术 老年 股骨颈骨折 髋关节功能 并发症 

分 类 号：R687.4[医药卫生—骨科学]