人工股骨头置换术和全髋关节置换术治疗股骨颈骨折的对比研究

目的比较人工股骨头置换术和全髋关节置换术治疗股骨颈骨折的手术效果。方法将我院2008年1月-2010年3月行人工股骨头置换术（FHR）的32例患者设立为A组，另选择同期行人工全髋关节置换术（THR）的30例患者作对照，设立为对照组。结果与B组比较，A组手术时间短，术中平均出血量少，具有统计学意义（P〈0．05）。但A组患者术后下床活动时间长于B组，具有统计学意义（P〈0．05）。术后B组Hamis髋关节功能评分优良率达83-3％，明显高于A组，X^2=7．932，差异存在统计学意义（P〈0．05）。A组发生感染、下肢静脉血栓、坠积性肺炎、褥疮的例数与B组比较，丽组间差异无统计学意义（P〉0．05），术后随访时间6-32个月，平均14．2个月，结果显示，A组发生假体松动、中心性脱位、异位骨化、假体周围骨折的例数明显多于B组，P〈0．05，差异存在统计学意义。结论人工股骨头置换术和全髋关节置换术治疗股骨颈骨折各具优缺点，临床医生应掌握好适应证和做好充分的围手术期准备，才可以提高手术的效果。

Comparative study of hemiarthroplasty and total hip arthroplasty for femoral neck fractures

Objective To compare hemiarthroplasty and total hip arthroplasty for femoral neck fractures.Methods From January 2008 to March 2010,32 patients row hemiarthroplasty(FHR) was established as a Group A,the other option concomitant artificial hip replacement(THR) of 30 patients as control group.Results Compared with group B,surgical time was short,the mean blood loss of group A was less,there was statistically significant difference(P < 0.05).But in group A patients after surgery to get out of bed activity was longer than group B,there was statistically significant difference(P < 0.05).The Harris hip score excellent rate of group A was 98.3%,the Group B was significantly higher than group A,χ2=7.932,P < 0.05,the differences was statistically significant.Infection,deep vein thrombosis,hypostatic pneumonia,bedsores number of patients Group A was compared with group B,there was significant difference(P > 0.05).Followed up from 6 to 32 months,periprosthetic fractures of loosening of the prosthesis center dislocation,heterotopic ossification,the number of A group was significantly higher than group B(P < 0.05),the difference was statistically significant.Conclusion Hemiarthroplasty hip arthroplasty for femoral neck fracture,each with advantages and disadvantages,clinicians should have a good indications and do the full perioperative preparation,we can improve the effect of the surgery.