【摘要】 目的探究股骨头置换术中应用骨水泥对患者凝血功能、骨折愈合进度和术后关节功能的影响。方法回顾性分析2016年1月至2017年2月在黄石市中心医院骨关节外科进行股骨头置换手术的156例患者的诊疗资料,根据其股骨头材料的不同分为生物型组(对照组)和骨水泥组(观察组),每组78例。比较两组患者的手术时间、出血量和凝血功能相关指标,同时,比较两组患者术后关节功能、骨折愈合进度及近远期并发症发生率。结果观察组患者的手术时间明显长于对照组,差异有统计学意义(P<0.05),而其术中出血量、术后引流量、输血量及卧床时间明显高于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者凝血酶原时间(PT)、激活部分凝血酶原时间(APTT)水平明显降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者的纤维蛋白原(FIB)、血小板(PLT)水平明显升高,且观察组高于对照组,差异均有统计学意义(P<0.05);术前,两组患者的Harris评分和Barthel评分比较差异均无统计学意义(P>0.05),术后3个月,观察组患者的Harris评分及Barthel评分明显高于对照组,差异均有统计学意义(P<0.05),但术后6个月,两组患者的Harris评分和Barthel评分比较差异均无统计学意义(P>0.05);两组患者的近期并发症发生率比较差异无统计学意义(P>0.05),但观察组患者的远期并发症发生率仅为5.13%,明显低于对照组的15.38%,差异具有统计学意义(P<0.05)。结论股骨头置换术中应用骨水泥可以明显改善患者的凝血功能,加快骨折愈合,促进患者关节功能的恢复,具有较好的近期疗效。更多还原

【Abstract】 Objective To investigate the effect of bone cement on coagulation function, fracture healing progress and postoperative joint function in patients undergoing femoral head replacement. Methods A retrospective analysis of 156 patients was conducted, who underwent femoral head replacement surgery in the Department of Osteoarticular Surgery in Huangshi Central Hospital from January 2016 to February 2017. They were divided into biotype groups(control group) and bone cement group(observation group) according to the different materials of the femoral head, with 78 cases in each group. The operation time, blood loss and coagulation function related indexes were compared between the two groups. At the same time, the postoperative joint function, fracture healing progress and the incidence of short-term and long-term complications were compared between the two groups. Results The operation time of the observation group was significantly longer than that of the control group, while the intraoperative blood loss, postoperative drainage volume, blood transfusion volume and bed rest time were significantly higher than those of the control group(P<0.05).After treatment, the levels of prothrombin time(PT) and activated partial prothrombin time(APTT) were significantly reduced in both groups, and the data of observation group was significantly lower than that of the control group(P<0.05).The levels of fibrinogen(FIB) and platelet(PLT) were significantly increased in both groups, and the results of observation group were higher than those of the control group(P<0.05). There were no significant differences in Harris score and Barthel score between the two groups before surgery(P>0.05); at 3 months after operation, the Harris score and Barthel score of the observation group were significantly higher than those of the control group(P<0.05); but at 6 months after surgery, there were no significant differences in Harris score and Barthel score between the two groups again(P>0.05). There was no statistically significant difference in the incidence of recent complications between the two groups(P>0.05), however, the long-term complication rate of the observation group was only 5.13%, which was significantly lower than 15.38 of the control group(P<0.05). Conclusion The application of bone cement in the replacement of femoral head can significantly improve the coagulation function of the patients, accelerate the healing of the fracture, and promote the recovery of joint function in patients. It has a good short-term effect and is worthy of clinical application.更多还原