老年股骨颈骨折患者内固定与关节置换术后近期生存质量的比较分析

目的：比较切开复位内固定术与全髋关节置换术治疗股骨颈骨折术后老年患者的生存质量。方法回顾性分析了2011年1月至2012年12月在我科室手术治疗股骨颈骨折的老年患者89例。其中行切开复位内固定手术治疗的为对照组，行全髋关节置换术治疗的为观察组。采用Harris评分及SF-36量表评估患者术后1个月、2个月、3个月、6个月及12个月等不同时间点的生存质量。结果共75例患者获得全程随访，随访时间为12个月。前3个月Harris评分及优良率观察组均高于对照组，有统计学差异（P＜0.05）；第6个月及第12个月比较两组间无统计学差异（P＞0.05）；前两个月SF-36量表躯体健康评分观察组高于对照组，有统计学差异（P＜0.05）；第3个月、第6个月及第12个月两组间比较均无统计学差异（P＞0.05）；而SF-36量表精神健康评分两组间比较均无统计学差异（P＞0.05）。结论老年股骨颈骨折患者无论采取切开复位内固定术还是全髋关节置换术治疗，患者术后半年至1年即能获得满意的生存质量；但由于全髋关节置换术治疗患者比切开复位内固定术治疗患者能够更早下床活动，术后并发症相对较少，故患者能够更早获得满意的近期生存质量。

Analysis of the quality of post-surgery life of the old patients who suffered femoral neck fracture

Objective Our study aimed to conducting a comparative study concerning To compare the quality of life in the treatment of femoral neck fracture in old patients with open reduction and internal fixation and total hip arthroplasty. Methods A total of 89 femoral neck fracture old patients treated in our department were retrospectively analyzed from January ,2011 to De-cember,2012. Patients treated with open reduction and internal fixation were divided into the control group, while patients treated with total hip arthroplasty were divided into the study group. The quality of life in both groups were quantified with Harris Hip Score and SF-36 Scale at 1month,2months,3months,6months and 12 months follow-up time postoperatively. Results 75 patients were got 12 months follow-up in our study. The Harris Hip Score and the excellent rate in the study group was higher in the study group than the control group at the first 3 months （P〈0.05）,while it was no significance between them at the 6 months and 12 month follow-up time （P〉0.05）. It revealed higher physical health scores of subset of the SF-36 Scale in the study group com-pared to the control group at the first 2 months （P〈0.05）, while the metal health scores of subset of the SF-36 Scale showed no significance during the whole follow-up time （P〉0.05）. Conclusion It’s ought to perform surgeries for the femoral neck fracture old patients as soon as possible. Patients can obtain good outcomes of the quality of life whatever surgeries performed（open reduc-tion and internal fixation or total hip arthroplasty） at 6 months to 12 months postoperatively. However, patients who had underwent total hip arthroplasty can obtain earlier off-bed training,less postoperative complications as well as earlier satisfaction compared to patients who had underwent open reduction and internal fixation.