人工关节置换术治疗老年人髋关节疾患的疗效观察

对１７８例应用人工髋关节置换术治疗老年人髋关节疾病患者进行了１～１３年的随访观察，获得完整资料８６例。采用国内北戴河髋关节功能评分标准，分股骨颈新鲜骨折和陈旧骨折，应用骨水泥固定与未用骨水泥固定，进行了临床疗效比较和评价。结果表明：人工股骨头置换术是治疗老年人股骨颈骨折的一种较好方法，特别适用于老年人股骨颈头下型新鲜骨折。对陈旧性股骨颈骨折髋臼已有病变者，宜选用全髋置换术。是否应用骨水泥固定，比较其中、长期疗效无显著差异，但有骨质疏松者以采用骨水泥固定为好。还对术后并发症发生原因进行了分析和探讨，并提出了一些有效的防治措施。

Clinical Effects of Artificial Hip Replacement in the Treatment of the Hip Diseases of Old People

old patients with hip diseases underwent the artificial hip replacement in our hospital and were followed up from 1 to 13 years. Complete data were obtained in the 86 patients. Acording to the Bei Daihe score system, the patients were divided into the group of fresh femoral neck fracture and the group of old fracture, the cemented fixation group and the noncemented group. Therapeatic comparison and evaluation were clinically performed. The results showed that artificial femoral head replacement was a kind of effective method for the management of femoral neck fracture of old patients. The excellent therapeutic rate of the fresh fracture was higher than the old fracture. The patients who had an old femoral neck fracture with acetabular injury was more suitable to receive total hip replacement. The long term results in the cemented fixation group and the noncemented fixation group showed no statistical difference.Cemented fixation is a kind of good method for the prosthesis fixation,especilly for the patients with osteoporosis. In addition,the main causes of complications after operation,as well as its prophylaxis and management were also discussed.