摘要
目的探讨全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的效果。方法选取2009年1月～2013年1月我院收治的78例老年股骨颈骨折患者，按随机数字表法分为A组和B组，各39例。A组给予全髋关节置换术，B组给予半髋关节置换术。观察两组患者手术时间、术中出血量、住院时间及术后并发症。术后1年进行随访，比较两组患者髋关节功能。结果A、B组患者手术时间分别为（98．5±9．8）、（70．0±10．1）min，手术出血量分别为（369．6±125．0）、（259．0±104．3）ml，差异有统计学意义（P〈0．05）；两组患者住院时间比较，差异无统计学意义（P〉0．05）；A组患者术后并发症发生率为33．3％（13／39），B组为35．9％（14／39），差异无统计学意义（P〉0．05）；但A组中术后有6例患者出现人工关节脱位，在麻醉下均闭合复位牵引后愈合，无复发；B组7例患者术后出现髋臼磨损，有疼痛和关节活动受限，未见关节脱位现象。术后1年进行随访，A组患者髋关节功能优于B组，差异有统计学意义（P〈0．05）。结论半髋关节置换术和全髋关节置换术治疗老年股骨颈骨折各有优劣，可根据患者的具体情况选择术式，但尽量选用全髋关节置换术，以提高患者的生活质量。
Objective To investigate the clinical effect of total hip replacement and half hip replacement for treatment of femoral neck fracture in elderly patients.Methods 78 cases of elderly patients with femoral neck fracture were selected as our subjects,who were hospitalize in our hospital from January 2009 to January 2013.They were randomly di- vided into A group（39 cases）and B group（39 cases）.The patients in A group were treated with total hip replacement and the patients in B group were treated with half hip replacement.The duration of operation,intraoperative blood loss,length of hospital stay and incidence of postoperative complication in both groups were recorded.The recovery of hip function in A group and in B group were compared in 1 year after operation.Results The duration of operation in A group[（98.5± 9.8） min] was longer than that of B group [（70.0±10.1） min] （P〈0.05）.The intraoperative blood loss in A group[（369.6± 125.0） ml] was more than that of B group [（259.0±104.3） ml]（P〈0.05）.The length of hospital stay in two groups had no significant difference （P〉0.05）.The incidence of postoperative complication was 33.3%（13/39） in A group and was 35.9%（14/39） in B group.There was no significant difference between two groups （P〉0.05）. Artificial joint dislocation occurred in 6 patient in A group and they were treated with closed reduction and traction under nerve blocking anes- thesia.Acetab abrasion,pain and limited range of motion occurred in 7 patient and no artificial joint dislocation oc- curred in all patient in B group.The recovery of hip function in A group was superior to that in B group in 1 year after operation （P〈0.05）.Conclusion Total hip replacement and half hip replacement for treatment of femoral neck fracture have advantages respectively in elderly patients.Operation method should choose according to the specific condition of patients.Total hip replacement for treatment of femoral neck fracture can improve patient＇s quality of life in elderly patients.
出处
《中国当代医药》
2016年第22期82-84,共3页
China Modern Medicine
关键词
股骨颈骨折
老年人
全髋关节置换术
半髋关节置换术
髋关节功能
Femoral neck fracture
Elderly patients
Total hip replacement
Half hip replacement
Hip joint function
