双动全髋关节置换术治疗偏瘫侧股骨颈骨折的临床效果观察  

Clinical effect of dual mobility total hip arthroplasty for the treatment of femoral neck fracture of the hemiplegic side

作　　者：尹巍 马宁 姜龙 吴思文 赵丽丽 YIN Wei;MA Ning;JIANG Long;WU Si-wen;ZHAO Li-li(Department of Orthopaedics,Mudan River Forestry Central Hospital of Heilongjiang Province,Mudanjiang Heilongjiang 157000,China;Department of Anesthesiology,Mudan River Forestry Central Hospital of Heilongjiang Province,Mudanjiang Heilongjiang 157000,China;Department of General Practice,Hongqi Hospital Affiliated to Mudanjiang Medical University,Mudanjiang Heilongjiang 157000,China)

机构地区：[1]黑龙江省牡丹江林业中心医院骨科,黑龙江牡丹江157000 [2]黑龙江省牡丹江林业中心医院麻醉科,黑龙江牡丹江157000 [3]牡丹江医科大学附属红旗医院全科医学科,黑龙江牡丹江157000

出　　处：《局解手术学杂志》2025年第4期320-324,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：黑龙江省卫生健康委科研课题(20220303020984)。

摘　　要：目的验证双动全髋关节置换术治疗偏瘫侧股骨颈骨折的临床疗效及安全性。方法选取2021年3月至2023年3月在我院行髋关节置换术的偏瘫合并股骨颈骨折患者为研究对象,随机分为双动全髋组(行双动全髋关节置换术)和半髋组(行半髋关节置换术),每组31例。统计并对比2组患者围术期情况、术后髋关节功能和术后并发症发生情况。结果双动全髋组患者手术时间长于半髋组,差异有统计学意义(P<0.05),但2组患者术中出血量、术后3 d总引流量及住院时间比较,差异均无统计学意义(P>0.05)。术后1个月,2组患者髋关节Harris评分差异无统计学意义(P>0.05);术后6个月和术后12个月,双动全髋组患者髋关节Harris评分均优于半髋组,差异有统计学意义(P<0.05)。在术前偏瘫侧肌力不同的情况下,双动全髋组患者术后6个月和术后12个月的髋关节Harris评分均优于半髋组,差异有统计学意义(P<0.05)。双动全髋组术后并发症发生率为12.9%(4/31),半髋组为22.6%(7/31),2组比较差异无统计学意义(P>0.05)。结论对于因偏瘫导致患肢肌力下降的股骨颈骨折患者,使用双动全髋关节置换术治疗可获得良好的术后功能及防脱位效果。Objective To investigate the clinical effects and safety of dual mobility total hip arthroplasty for the treatment of femoral neck fracture of the hemiplegic side.Methods Patients with hemiplegia and femoral neck fracture who underwent hip arthroplasty in our hospital from March 2021 to March 2023 were selected as the research objects,and they were randomly divided into the dual mobility group(dual mobility total hip arthroplasty was performed)and the hemiarthroplasty group(hemiarthroplasty was performed),with 31 cases in each group.The perioperative status,postoperative hip function and postoperative complications of patients in the two groups were analyzed and compared.Results The operative time of patients in the dual mobility group was longer than that in the hemiarthroplasty group,the difference was statistically significant(P<0.05),but there was no statistically significant difference in intraoperative blood loss,total drainage volume 3 days after operation or hospital stay between the two groups(P>0.05).One month after surgery,there was no significant difference in hip Harris score between the two groups(P>0.05).At 6 months and 12 months after surgery,the hip Harris scores of patients in the dual mobility group were better than those in the hemiarthroplasty group,and the differences were statistically significant(P<0.05).In the case of different preoperative muscle strength of the hemiplegic side,the hip Harris scores of patients in the dual mobility group at 6 months and 12 months after surgery were better than those in the hemiarthroplasty group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications was 12.9%(4/31)in the dual mobility group,and it was 22.6%(7/31)in the hemiarthroplasty group,without significant difference between the two groups(P>0.05).Conclusion For patients with femoral neck fracture and decreased muscle strength of affected limb due to hemiplegia,the use of dual mobility total hip arthroplasty can achieve good postoperative function and

关 键 词：双动全髋关节 关节置换术 偏瘫 股骨颈骨折 

分 类 号：R684.1[医药卫生—骨科学]