【摘要】 目的评价全髋关节置换术与双极股骨头置换术治疗高龄股骨颈骨折患者的治疗效果。方法回顾南阳市第二人民医院70岁以上行髋关节置换术的股骨颈骨折患者68例68髋的病历资料,按照手术方式分为全髋关节置换组(30例)和双极股骨头置换组(38例)。全部病例平均随访(35.4±3.2)个月,主要从围手术期相关指标(麻醉时间、手术时间、术中出血量、术后下床活动时间及住院天数)与功能恢复情况(Harris评分、总活动范围及髋疼)两方面进行比较。结果 (1)全髋关节置换组与双极股骨头置换组的平均麻醉时间分别为(114.8±18.3)min、(76.5±12.7)min,两组比较差异有统计学意义(P<0.05)。两组平均手术时间分别为(111.5±12.9)min、(63.1±10.4)min,差异有统计学意义(P<0.05)。两组平均术中出血量分别为(433.7±100.5)ml、(328.1±86.7)ml,差异有统计学意义(P<0.05)。(2)两组患者平均住院时间与术后下床活动时间比较差异无统计学意义。(3)全髋关节置换组与双极股骨头置换组的Harris评分平均值分别为78.2±6.3、63.7±7.6,两组比较差异有统计学意义(P<0.05)。(4)随访期间两组患者术后髋痛发生率比较,差异无统计学意义。结论两种置换术均是治疗高龄股骨颈骨折患者的有效方法,就术后疗效(髋关节活动范围及Harris评分)来看,全髋关节置换术疗效优于双极股骨头置换术;针对不同患者,需综合考虑其全身健康状况、术前的生活状态、活动量、预期寿命等因素,选择具体术式。更多还原

【Abstract】 Objective To explore therapeutic effect of joints in patients over 70 years with femoral neck fracture by total hip replacement and bipolar artificial femoral head replacement. Methods Sixty-eight patients with femoral neck fracture over 70 years were enrolled in our hospital. There were 30 cases receiving total hip replacement,while 38 cases received bipolar artificial femoral head replacement,the mean time of follow-ups for all patients was 36 months. The difference was compared in time of operation,blood loss,time of hospitalization,Harris scoring and joint function. Results( 1) The average operation time were 115. 9 ± 12. 9 and 63. 1 ± 10. 4 minutes respectively in group of total hip replacement and bipolar artificial femoral head replacement,with significant difference( P < 0. 05). The blood loss was 433. 7 ± 100. 5 ml in total hip replacement group and 328. 1 ± 86. 7 ml in the other one,with significant difference( P <0. 05).( 2) There was no significant difference between two groups in hospitalization time( P > 0. 05).( 3) The average Harris score was78. 2 ± 6. 3 in total hip replacement group,63. 7 ± 7. 6 in the other one,and the difference was significant( P < 0. 05).( 4) There was no significant difference between two groups in adverse effect. Conclusions Both replacements are reliable to treat femoral neck fractures in elderly. For postoperative efficacy,total hip arthroplasty is more effective than bipolar artificial femoral head replacement. Selection of treatment methods for femoral neck fracture in the elderly patients depends on health condition,life state and activity level and life expectancy preoperatively.更多还原