全髋关节置换术与股骨头置换术治疗老年股骨颈骨折的效果对比

目的探讨分析全髋关节置换术与股骨头置换术治疗老年股骨颈骨折的疗效,为临床应用提供依据。方法回顾性分析河南省周口市中心医院2014年1—4月接诊的85例老年股骨颈骨折患者的资料,其中采取全髋关节置换的患者50例(髋关节组),采取人工股骨头置换术的患者35例(股骨头组)。比较两组围手术期情况、术前及术后1年生活质量及术后并发症;于术后1年,比较临床疗效优良率。结果髋关节组手术时间(123.58±21.34)min,明显比股骨头组手术时间长(76.86±13.26)min,术中出血量(428.12±65.60)m L、术后引流量(164.94±25.63)m L,明显多于股骨头组(229.45±35.86)m L、(97.56±19.43)m L;髋关节组术后优良率78.00%,明显高于股骨头组54.28%(P0.05);术后1年,两组患者生活质量较手术前均显著改善(P0.05),髋关节组活力、躯体疼痛、生理功能、社会功能、生理职能、情感职能、总体健康结果均明显高于股骨头组(P0.05);两组术后并发症总发生率无明显差异(P0.05)。结论在老年股骨颈骨折患者中,采用全髋关节置换术远期疗效更为显著,而采用人工股骨头置换术操作简单、创伤更小;临床上可根据患者股骨颈骨折具体情况和患者身体状况等选择最佳的手术方案。

Comparative analysis of hip replacement and femoral head replacement for treatment of femoral neck fractures in elderly patients

Objective To explore the efficacy of total hip arthroplasty and femoral head replacement in the treatment of senile femoral neck fracture ,and to provide a basis for clinical application.Methods A retrospective analysis of 85 elderly patients with femoral neck fracture in Henan Zhoukou City Centre Hospital (hereinafter referred to as "our hospital") during Jan.and Apr.2014 was carried out.Fifty cases were treated with total hip replace-ment (hip group),and 35 patients with artificial femoral head replacement surgery (femoral head group).The peri-operative condition,preoperative and postoperative life quality and postoperative complications were compared be -tween the two groups.After 1 year,the clinical efficacy was compared.Results Surgery time in the hip group (123.58 ±21.34)min]was significantly longer than in the femoral head group (76.86 ±13.26)min],intraoper-ative blood loss (428.12 ±65.60) mL] and postoperative drainage (164.94 ±25.63) mL] were significantly more than those of the femoral head group of (229.45 ±35.86)mL,(97.56 ±19.43)mL.The postoperative posi-tive rate of the hip joint group was 78.00%,which was significantly higher than that of the femoral head group (54.28%,P＜0.05).After one year,quality of life in two groups of patients were significantly improved than be-fore surgery(P＜0.05).The hip group vigor,body pain,physical function,social function,physical function,emo-tional function,overall health outcomes were significantly better than the femoral head group (P＜0.05).There was no significant difference in the total incidence of postoperative complications (P＜0.05).Conclusion In elderly patients with femoral neck fracture ,the long-term effect of total hip arthroplasty is more significant ,and the operation of artificial femoral head replacement is simple and less traumatic.Clinically,the best surgical option can be chosen according to the specific condition of femoral neck fracture and the patient's own physical condition.