骨水泥型与非骨水泥型人工半髋关节置换术治疗高龄股骨颈骨折患者的对比研究

目的对比骨水泥型与非骨水泥非骨水泥型人工半髋关节置换术在高龄股骨颈骨折患者中的治疗效果。方法前瞻性收集2014年1月至2018年12月期间行唐县人民医院收治的112例高龄股骨颈骨折患者为研究对象,采用随机数字表法将患者分为骨水泥组、非骨水泥组,每组各56例。骨水泥组患者给予骨水泥型人工半髋置换手术治疗,男26例,女30例,年龄(72±4)岁。非骨水泥组给予非骨水泥人工半髋关节置换术治疗,男31例,女25例,年龄(73±4)岁。对比两组患者围术期相关指标、手术效果、并发症发生率,并对两组患者术后进行为期3年的随访观察,对患者在随访期间的Harris髋关节功能评分、不良事件发生率等进行统计对比。结果 112例患者获得完整随访,随访时间(36±5)个月。两组患者手术时间、术中失血量、引流量等差异无统计学意义(P>0.05),而骨水泥组患者的住院时间[(14±3)d]、开始负重时间[(41±9)d]均低于非骨水泥组[(17±3)d、(46±10)d](t=4.353,2.856,P<0.05)。骨水泥组手术优良率为87.50%(49/56),高于非骨水泥组71.43%(40/56)(χ^2=4.432,P<0.05)。骨水泥组术后并发症发生率为7.14%(4/56),低于非骨水泥组的21.43%(12/56)(χ^2=4.667,P<0.05)。骨水泥组患者的Harris评分在术后6个月[(82±14)分]、12个月[(86±8)分]、24个月[(91±7)分]、36个月[(95±4)分]均优于非骨水泥组[(76±11、81±9、87±8、91±6)分]。骨水泥组不良事件发生率为8.93%(5/56),低于非骨水泥组的23.21%(13/56)(χ^2=4.236,P<0.05)。结论相较于非骨水泥型人工半髋关节,骨水泥型人工半髋关节置换术对于高龄股骨颈骨折患者的手术效果更好,术后关节功能恢复好,值得临床推荐。

A comparative analysis of cemented and non cemented hemiarthroplasty in the treatment of femoral neck fracture in the elderly

ObjectiveTo compare the effect of cemented and non-cemented non-cemented artificial hip arthroplasty in elderly patients with femoral neck fracture. MethodsA prospective collection of 112 elderly patients with femoral neck fractures admitted to Xingtang County People's Hospital from January 2014 to December 2018 were done. The patients were divided into cemented and non-cemented groups by a random number table. 56 cases in each group. Patients in the cement group were treated with cement-type artificial hemi hip replacement. There were 26 males and 30 females, aged (72±4) years. The non-cemented group was treated with non-cemented artificial hip arthroplasty. There were 31 males and 25 females, aged (73±4) years old. The perioperative indicators, surgical effects, and complication rates of the two groups of patients were compared, and the two groups were followed up for 3 years after the operation. The Harris hip function score and the incidence of adverse events during the follow-up period were evaluated and statistical analyzed. Results112 patients were followed up completely, and the follow-up time was (36±5) months. There was no statistically significant difference in operation time, intraoperative blood loss, drainage volume, etc. between the two groups (P>0.05), while the hospitalization time of the bone cement group was (14±3) days and the time to start weight bearing (41±9) days were both lower than the non-cemented group [(17±3)d, (46±10)d, t=4.353, 2.856, P<0.05]. The excellent and good rate of surgery in the cement group was 87.50% (49/56), which was higher than the non-cement group [71.43% (40/56), χ²=4.432, P<0.05]. The postoperative complication rate in the cement group was 7.14% (4/56), which was lower than the non-cement group [21.43% (12/56), χ²=4.667, P<0.05]. Harris scores of patients in the bone cement group were better than the cement group (76±11, 81±9, 87±8, 91±6) at 6 months (82±14), 12 months (86±8), 24 months (91±7) and 36 months (95±4) after surgery. The incidence of adverse events in the cement group was 8.93% (5/56), which was lower than that of the non-cement group [23.21% (13/56), χ²=4.236, P<0.05]. ConclusionCompared with non-cemented artificial hip joints, cemented artificial hip joint replacements have better surgical results for elderly patients with femoral neck fractures and good postoperative joint function recovery, which is worthy of clinical recommendation.