人工股骨头置换术和全髋关节置换术治疗老年股骨颈骨折的疗效观察

目的：探讨人工股骨头置换术和全髋关节置换术治疗老年股骨颈骨折患者的临床疗效。方法：选取在我院行人工股骨头置换术（Ⅰ组）及全髋关节置换术（Ⅱ组）的老年股骨颈骨折患者各34例,总结分析两组患者手术持续时间、术中出血量、术后引流量、早期并发症,并对所有患者进行追踪随访,观察远期治疗效果。结果：Ⅰ组患者手术时间明显短于Ⅱ组患者,Ⅰ组患者术中出血量及术后引流血量明显少于Ⅱ组患者,两者比较差异均具有统计学意义（P〈0.05）。Ⅰ组患者术后早期并发症发生率为5.88%,Ⅱ组早期并发症发生率为8.82%,两者比较差异无统计学意义（P〉0.05）。本组患者术后随访3~5年,术后1年两组患者Harris评分及优良率差异无统计学意义（P〉0.05）;术后3年Ⅱ组患者Harris评分及优良率明显高于Ⅰ组,术后5年Ⅱ组患者Harris评分及优良率明显高于Ⅰ组,两组比较差异具有统计学意义（P〈0.05）。结论：两种术式各具有优缺点,近期效果基本相同,全髋关节置换术远期效果优于人工股骨头置换术。

Observation the Effects of Artificial Femoral Head Replacement and Replacement of Total Hip in Treatment of Femoral Neck Fracture in Older

Objectiv placement of total hip in e： To investigate the clinical effects of artificial femoral head replacement and retreatment of femoral neck fracture in older. Method ： 34 cases in Ⅰ group with artificial femoral head replacement and Ⅱ group with replacement of total hip respectively were seleceted, and the duration of operation, hemorrhage in operation, drainage after operation and early complication were observed, and the patients were followed - up to observe the long - term effect. Result： The duration of operation in Ⅰ group was shorter than that in Ⅱ group, the hemorrhage in operation and drainage after operation in Ⅰ group was fewer than those in Ⅱ group, and there was significant difference between two groups （ P 〈 0. 05）. The rate of early complication were 5.88% in Ⅰ group and were 8.82% in Ⅱ group,and there was no significant difference between two groups （ P 〉 0.05 ）. The patients in two groups were followed - up for 3 to 5 years, there was no significant difference between two groups on Harris scores and the fineness rate after one year（ P 〉0.05 ）, but there was significant difference between two groups on Harris scores and the fineness rate after 3 years and 5 years （ P 〈 0.05 }. Conclusion： There are many advantages and shortcomings about two operations and their effects are the same in the near future, but the long - term effect of replacement of total hip in treatment is superior to that of artificial femoral head replacement.