老年髋部骨折内固定与人工髋关节置换术的临床疗效比较

目的比较老年髋部骨折内固定与人工髋关节置换术的临床疗效。方法选取2016年1月～2017年1月我院收治的60例髋部骨折患者,按照随机数字表法分为研究组和对照组,每组各30例。研究组采用人工髋关节置换术治疗,对照组采用老年髋部骨折内固定治疗。观察并比较两组患者的手术时间、术中出血量、骨折愈合时间、住院时间及术前、术后3、6个月Harris评分、并发症情况。结果研究组的手术时间显著短于对照组,术中出血量明显少于对照组,骨折愈合时间快于对照组,术后住院时间短于对照组,两组组间比较,差异具有统计学意义(P0.05)。研究组与对照组患者术后3个月的Harris评分分别为(79.95±6.21)分、(73.85±12.53)分,两组组间比较,差异具有统计学意义(P0.05)。研究组与对照组患者术后6个月的Harris评分分别为(86.73±5.19)分、(80.24±8.12)分,两组组间比较,差异具有统计学意义(P0.05)。且研究组患者术后6个月的Harris评分分别明显高于术前及术后3个月,差异具有统计学意义(P0.05)。所有患者均顺利完成手术,研究组患者的并发症发生率为10.0%,显著低于对照组,差异具有统计学意义(P0.05)。结论人工髋关节置换术治疗髋部骨折疗效显著优于内固定,有利于促进患者术后愈合、改善髋关节功能,减少术后并发症。

Comparison of the clinical effects of internal fixation and hip arthroplasty for hip fracture in the elderly

Objective To compare the clinical effects of internal fixation and hip arthroplasty for hip fracture in the elderly. Methods 60 patients with hip fracture treated in our hospital from January 2016 to January 2017 were selected and randomly divided into the study group and the control group with 30 cases in each group. The study group was treated with hip arthroplasty, while the control group was treated with internal fixation for hip fractures. The operation time, the amount of bleeding, the time of fracture healing, the time of hospitalization and the preoperative Harris scores,the score 3 and 6 month after the operation and the complications in the two groups were observed and compared. Results The operation time of the study group was significantly shorter than that of the control group. The amount of bleeding during the operation was significantly less than that of the control group. The time of fracture healing was shorter than that of the control group. The time of hospitalization was shorter than that of the control group. There were significant differences between the two groups (P<0.05). The Harris scores of the study group and the control group 3 months after operation were (79.95±6.21) and (73.85±12.53) respectvely, and the difference between the two groups was significant (P<0.05). The Harris scores of the study group and the control group 6 months after operation were (86.73±5.19) and(80.24±8.12) respectively, and the difference between the two groups was significant(P<0.05). The Harris score 6 months after operation of the study group was significantly higher than that before and 3 months after operation (P<0.05). All patients completed the operation successfully. The incidence rate of complications in the study group was 10.0%, which was significantly lower than that in the control group(P<0.05). Conclusion Artificial hip replacement has better clinical effect than internal fixation in the treatment of hip fracture. It is beneficial to promote the healing of the patients, improve the function of the hip joint and reduce the postoperative complications.