老年股骨颈骨折髋关节置换的方式选择及疗效分析

目的研究半髋关节置换术和全髋关节置换术治疗老年股骨颈骨折的临床效果。方法选择2010年8月至2013年1月由东莞市石龙博爱医院收治的老年股骨颈骨折患者作为研究对象,根据手术方式不同将65例入组患者随机分为给予半髋关节置换术组33例和全髋关节置换术组32例,观察手术相关指标以及远期关节功能。结果全髋关节置换术组患者的手术时间、术中出血量、术后引流量分别为(86.3±9.3)min、(67.23±8.93)mL、(32.32±3.84)mL;半髋关节置换术组上述指标分别为(91.3±9.8)min、(72.23±8.42)mL、(33.25±4.21)mL,两组比较差异无统计学意义。全髋关节置换术组的术后卧床时间显著低于半髋关节置换术组[(4.05±0.53)min vs(7.81±1.18)min](P<0.05)。全髋关节置换术组患者术后半年及1年时的Harris评分分别为(67.5±8.3)分、(70.4±9.5),HSS评分分别为(92.3±14.9)分、(96.2±15.2)分;而半髋关节置换术组患者术后半年以及1年时的Harris评分分别为(55.2±7.1)分、(59.3±7.9)分,HSS评分分别为(84.8±10.3)分、(89.3±10.2)分,全髋关节置换术组的评分显著高于半髋关节置换术组(P<0.05)。结论全髋关节置换术能够在不增加手术创伤的基础上促进术后恢复、改善关节功能,具有积极的临床价值。

Study on the Operation Mode Selection and Curative Effect of Hip Replacement in Treating Elderly Patient with Femoral Neck Fracture

Objective To study the clinical effect of hemi-hip replacement and total hip replacement in treating elderly patient with femoral neck fracture.Methods We collected 65 cases of elderly patients with femoral neck fracture admitted in Shilong Humanitarian Hospital from August 2010 to Janumy 2013,and randomly divided into two groups with 33 cases of total hip replacement and 32 cases of hemi-hip replacement.The operation related index and long-term joint function of the two groups were studied.Results There was no statistically significance of operation time,bleeding volume during operation,postoperative drainage between the total hip replacement group and hemi-hip replacement group,the above data of the total hip replacement group was （86.3 ± 9.3） min,（67.23 ± 8.93） mL,and（32.32 ± 3.84） mL respectively; while the data of the hemi-hip replacement group wad 91.3 ± 9.8） min,（72.23 ± 8.42） mL,and（33.25 ± 4.21） mL.Time of lying in bed after operation was significantly lower in the total hip replacement group than the hemi-hip replacement group[（4.05 ± 0.53） min vs （7.81 ± 1.18） min]（P 〈 0.05）.Harris scores andHSS scores in three months,six months and one year after operation of the total hip replacement group were significantly higher than those of the hemi-hip replacement group（P 〈 0.05）.Harris scores of the total hip replacement group were（67.5 ± 8.3）,（70.4 ± 9.5） respectively,HSS scores of the total hip replacement group were（92.3 ± 14.9）,（96.2 ± 15.2） respectively,Harris scores of the hemi-hip replacement group were（55.2 ± 7.1）,（59.3 ± 7.9） respectively,HSS scores of the hemi-hip replacement group were（84.8 ± 10.3）,（89.3 ± 10.2） respectively.Conclusion Total hip replacement has more positive clinical value in promoting postoperative recovmy and improving joint function without increasing operation wound than hemi-hip replacement.