【摘要】 [目的]探讨老年股骨颈骨折患者选择骨水泥型和生物型股骨假体治疗股骨颈骨折的疗效比较。[方法]回顾性分析2012年6月~2014年6月,选择同期进行人工股骨头置换的老年患者共151例。其中骨水泥型组65例,生物型组86例。记录并比较两组的临床资料、髋关节功能Harris评分和术后髋关节疼痛VAS评分。[结果]151例患者术后均获得1年以上的有效随访。生物型假体组在手术时间、术中出血方面要优于骨水泥假体组,差异具有统计学意义(P<0.05)。而骨水泥型假体组在术后引流量、术后部分负重、术后完全负重及住院时间方面要优于生物型假体组,差异具有统计学意义(P<0.05)。两组在术前和术后1年Harris评分差异均无统计学意义(P>0.05)。骨水泥型假体组在术后1、6个月时Harris评分均优于生物型假体组,差异具有统计学意义(P<0.05)。两组疼痛VAS评分在术前、术后2周、术后1、6个月时差异均无统计学意义(P>0.05)。两组相关并发症都得到积极有效的治疗,两组间并发症的差异均无统计学意义(P>0.05)。[结论]骨水泥型和生物型假体治疗老年股骨颈骨折均能获得满意的治疗疗效,可根据假体不同的特点结合患者的具体情况,选择最合适的治疗方式。更多还原

【Abstract】 [Objective]To compare the effectiveness of cemented prosthesis and uncemented prosthesis in the treatment of femoral neck fracture in the elderly. [Method]From June 2012 to June 2014,a total number of 151 cases of femoral neck fracture in elderly patients received artificial femoral head replacement,including bone cement in 65 cases,and with uncemented prosthesis in 86 cases. The clinical data during the surgery,Harris hip score and postoperative hip pain VAS score were recorded and compared between two groups. [Result]All 151 cases obtained the followed- up observation for more than 1 year. The operation time,intraoperative blood loss were better in uncemented group than those in cemented group,the difference had statistical significance( P < 0. 05). While the postoperative drainage volume,postoperative partial and full weight- bearing time,as well as length of hospital stay in cement group were better than those in uncemented group,the difference also had statistical significance( P < 0. 05). The preoperative and 1 year postoperative Harris score showed no statistically significant differences( P > 0. 05). At one month and half year postoperatively,Harris score in cemented group were higher than those in uncemented group( P < 0. 05). No significant difference was found on VAS score preoperatively,at two weeks,one month and half year postoperatively( P > 0. 05). Meanwhile,all postoperative related complications,indicating no significant difference between two groups as well( P > 0. 05),received timely and effective treatment. [Conclusion]Both cemented and uncemented prosthesis for the treatment of femoral neck fractures in the elderly can obtain satisfactory treatment effect. the most appropriate treatment should be selected according to characteristics of prosthesis and patient’s situation.更多还原