摘要
目的 研究初次全髋关节置换术治疗老年股骨颈骨折的效果及影响因素,提高髋关节功能恢复的优良率.方法 回顾性分析2014年1月至2016年3月110例初次接受全髋关节置换术治疗的股骨颈骨折老年患者的临床资料,探讨影响髋关节功能术后恢复的主要因素.对患者性别、年龄、体质量指数、致伤原因、骨折分型及术后功能锻炼时间等影响临床疗效的因素进行单因素分析,多因素分析采用Logistic回归分析.结果 110例老年股骨颈骨折患者初次接受全髋关节置换术治疗后,髋关节功能恢复优36例、良54例、可15例、差5例,优良率为81.8 %(90/110).单因素分析显示,体质量指数、术前合并内科疾病、手术入路方式、手术时间、总失血量、术后是否镇痛、双下肢长度差、术后功能锻炼时间及术后并发症与髋关节功能恢复有关,差异均有统计学意义(χ2值分别为8.528、12.742、9.912、8.131、10.404、10.171、12.406、6.412、10.362,P均<0.05).多因素分析结果显示,体质量指数、手术入路方式、总失血量、术后是否镇痛、双下肢长度差、术后功能锻炼时间是影响髋关节功能术后恢复的主要因素(Wald χ2值分别为6.213、4.543、9.156、6.287、5.461、3.698,95 % CI分别为1.17~6.74、1.43~9.15、1.03~5.82、1.29~9.35、0.05~0.62、0.12~0.93,P均<0.05).结论 初次全髋关节置换术治疗老年股骨颈骨折效果良好.体质量指数偏小、选择微创入路、缩短双下肢长度差、术后镇痛、减少总失血量及延长术后功能锻炼时间都有利于患者全髋关节置换术术后髋关节功能的恢复.
Objective To analyze the effects and influence factors of primary total hip arthroplasty in the treatment of senile femoral neck fractures,and to increase the excellent rate of hip joint function recovery.Methods Retrospective analysis was applied to study the clinical data of one hundred and ten senile femoral neck fractures patients who underwent primary total hip arthroplasty in the 210th Hospital of People's Liberation Army from January 2014 to March 2016,to explore the main factors affecting postoperative recovery of hip joint function.Univariate analysis was used to analyze the factors influencing the clinical efficacy of the patients in terms of gender,age,body mass index,cause of injury,type of fracture and postoperative rehabilitation time,and Logistic regression analysis was used for multivariate analysis.Results The 110 senile femoral neck fractures patients obtained primary total hip arthroplasty,36 cases have seen excellent hip joint function recovery,54 good,15 fair,and 5 poor,with an excellent rate of 81.8 %(90/110).Single factor analyses found that body mass index,preoperative concomitant diseases,surgical approach,operation time,total blood loss, postoperative analgesia,discrepancy in bilateral lower limb lengths,postoperative rehabilitation time and postoperative complications were significantly related to hip joint function recovery(χ2=8.528,12.742,9.912, 8.131,10.404,10.171,12.406,6.412,10.362,P<0.05).According to the multivariate analysis,body mass index,surgical approach,total blood loss,postoperative analgesia,discrepancy in bilateral lower limb lengths,and postoperative rehabilitation time were the main factors affecting hip joint function recovery(Wald χ2=6.213, 4.543,9.156,6.287,5.461,3.698,95%CI=1.17~6.74,1.43~9.15,1.03~5.82,1.29~9.35,0.05~0.62, 0.12~0.93,P<0.05).Conclusion Primary total hip arthroplasty may lead to excellent curative effects for elderly patients with femoral neck fracture.Smaller body mass index,minimally invasive approach,less discrepancy in bilateral lower limb lengths,postoperative analgesia,less total blood loss and longer postoperative rehabilitation time may facilitate postoperative recovery for hip joint function.
出处
《中国综合临床》
2017年第12期1108-1111,共4页
Clinical Medicine of China
关键词
全髋关节置换术
股骨颈骨折
老年
髋关节功能
影响因素
Total hip Arthroplasty
Femoral Neck Fracture
Senile
Hip Joint Function
Influencing Factor
