髋关节置换治疗老年性股骨颈骨折临床分析

目的：探讨在老年性股骨颈股骨折中进行髋关节置换术的临床作用。方法：选取本科室2009年1月-2013年1月收治的90例老年股骨颈股骨折患者，按照随机数字表法将其分为对照组和观察组各45例，其中对照组采用双极人工股骨头置换术治疗，观察组采用人工全髋关节置换术治疗，观察比较两组的治疗效果及手术时间、术中出血量、引流量、住院时间的差异。结果：观察组的手术时间明显长于对照组，术中出血量明显高于对照组，差异均有统计学意义（P〈0.05），但两组引流量和住院时间的比较差异均无统计学意义（P〉0.05）。观察组的优良率95.56%（43/45）明显高于对照组的66.67%（30/45），且随访3年的优良率均明显高于对照组，差异均有统计学意义（P〈0.05）。其中观察组第1年与第3年的优良率比较差异无统计学意义（P〉0.05），而对照组第1年与第3年的优良率比较差异有统计学意义（P〈0.05）。结论：经临床研究证明，全髋关节置换术治疗效果以及远期疗效均明显优于双极人工股骨头置换术，但手术时间以及出血量均明显多于双极人工股骨头置换术，因此可根据患者具体机体情况来选择合适的手术方法。

The Clinical Analysis of Hip Replacement in Treatment of Senile Femoral Neck Fracture

Objective：To explore the clinical effect analysis of hip replacement in treatment of senile femoral neck fracture.Method：90 elderly patients with femoral neck fracture were selected in our department from January 2009 to January 2013,they were divided into the control group and the observation group according to the random number table method,45 cases in each group.The control group was treated with bipolar artificial femoral head replacement,the observation group was treated with total hip arthroplasty.The treatment effect,operation time,intraoperative blood loss, volume of drainage and hospital stays between the two groups were observed and compared.Result：The operation time of observation group was significantly longer than the control group,the amount of bleeding was significantly more than the control group,the differences were statistically significant（P〈0.05）.There were no significant differences in drainage and hospitalization time between the two groups（P〉0.05）.The excellent and good rate of observation group was 95.56%（43/45）,it was significantly higher than the 66.67%（30/45）of control group,and the excellent and good rate of 3 years of follow-up were significantly higher than the control group,the differences were statistically significant（P〈0.05）. There was no significant difference on the excellent and good rate between the first year and the third year in observation group（P〉0.05）,there was significant difference on the excellent and good rate between the first year and the third year in control group（P〈0.05）.Conclusion：The clinical studies demonstrate that the treatment and the curative effect of total hip arthroplasty are significantly better than bipolar artificial femoral head replacement,but operation time and bleeding volume are significantly more than bipolar artificial femoral head replacement,according to the specific body circumstance for the patient to choose appropriate surgical method.