全髋与半髋关节置换术治疗老年股骨颈骨折的早期疗效比较
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摘要
目的比较采用全髋关节置换术(total hip arthroplasty,THA)或双极人工股骨头置换术(bipolar hemiarthroplasty,BHA)治疗老年股骨颈骨折2年的临床综合疗效。方法 128例60岁以上老年股骨颈骨折患者,分别接受THA(n=67)或BHA(n=61)治疗。对比THA组与BHA组的手术时间、术中出血量、输血量、平均住院日、并发症,术后髋关节功能(Harris评分)。结果术后平均随访时间为36.4个月。在对比THA组和BHA组的治疗上,手术时间、术中出血量、术后关节脱位率,存在统计学差异(P<0.05);输血量、平均住院费用、其余并发症、Harris髋关节评分均未见明显统计学差异。结论老年移位型股骨颈骨折的治疗选择需要根据患者的健康状况、术前生活质量和状态来决定,在患者条件容许的情况下,研究人员建议优先考虑全髋关节置换术。
Objective To compare clinical efficacy in treatment of femoral neck fracture with total hip arthroplasty(THA)and bipolar hemiarthroplasty(BHA)in elderly. Methods 128 patients over 60 years old with femoral neck fractures were treated with either THA(n= 67)or BHA(n = 61). Comparison between THA and BHA groups were carried out on operation duration, blood loss, blood transfusion,length of hospital stay, complication, postoperative Harris score. Results The patients were average followed up for 36.4 months. The blood transfusion, length of hospital stay, postoperative Harris score(P>0.05). The operation duration, blood loss, dislocation of hip joint(P >0.05). Conclusion The treatment of displaced femoral neck fracture in the elderly depends on the patient's health status,preoperative quality of life and status. We recommend that total hip arthroplasty be given priority when the patient's condition permits.
Objective To compare clinical efficacy in treatment of femoral neck fracture with total hip arthroplasty(THA)and bipolar hemiarthroplasty(BHA)in elderly. Methods 128 patients over 60 years old with femoral neck fractures were treated with either THA(n= 67)or BHA(n = 61). Comparison between THA and BHA groups were carried out on operation duration, blood loss, blood transfusion,length of hospital stay, complication, postoperative Harris score. Results The patients were average followed up for 36.4 months. The blood transfusion, length of hospital stay, postoperative Harris score(P>0.05). The operation duration, blood loss, dislocation of hip joint(P >0.05). Conclusion The treatment of displaced femoral neck fracture in the elderly depends on the patient's health status,preoperative quality of life and status. We recommend that total hip arthroplasty be given priority when the patient's condition permits.
引文
[1]梅仁富谌洪亮人工全髋关节置换术后感染的诊断和防治探讨[J].新疆医学,2015;(4):501-502.
[2]杜磊髋关节置换术后早期康复的重要性[J].新疆医学,2010;40(6):64-66.
[3]赵喜滨缪晓刚袁宏等人工全髋关节置换术在严重髋关节疾患中的应用[J].新疆医学,2006;36(1):32-34.
[4]Liu JM, Ning G, Chen JL. Osteoporotic fractures in Asia:risk factors and strategies for prevention.[J]. J Bone Miner Metab.2007;25(1):1-5.
[5]Marya SK, Thukral R, Singh C. Prosthetic replacement in femoral neck fracture in the elderly:results and review of the literature. Indian J Orthop. 2008 Jan;42(1):61-7.
[7]Bhandari M, Devereaux PJ, Tornetta P 3rd, et al. Operative management of displaced femoral neck fractures in elderly patients:an international survey. J Bone Joint Surg[Am] 2005;87-A:2122-30.
[8]Iorio R, Schwartz B, Macaulay W, et al. Surgical treatment of displaced femoral neck fractures in the elderly:a survey of the American Association of Hip and Knee Surgeons. J Arthroplasty 2006;21(8):1124-33.
[9]Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty:an end-result study using a new method of result evaluation. J Bone Joint Surg[Am] 1969;51-A:737-55.
[10]温荣彬,施国强,严昌琬.80岁以上患者人工股骨头置换术[J].中华创伤杂志,1995;(6):59-60.
[11]郝林杰,邱裕生,张育民,等.全髋与半髋置换术治疗老年人股骨颈骨折疗效比较[J].实用骨科杂志,2017,23(2):118-123.
[12]刘剑伟,蒋卫平.全髋置换术与半髋置换术治疗股骨颈骨折的疗效对比[J].实用骨科杂志, 2013,19(8):747-749.
[13]王宏伟孟昭宇吴超.人工股骨头置换术与全髋关节置换术治疗老年人股骨颈骨折的临床对比研究[J].医学综述,2015,(18):3447-3448.
[2]杜磊髋关节置换术后早期康复的重要性[J].新疆医学,2010;40(6):64-66.
[3]赵喜滨缪晓刚袁宏等人工全髋关节置换术在严重髋关节疾患中的应用[J].新疆医学,2006;36(1):32-34.
[4]Liu JM, Ning G, Chen JL. Osteoporotic fractures in Asia:risk factors and strategies for prevention.[J]. J Bone Miner Metab.2007;25(1):1-5.
[5]Marya SK, Thukral R, Singh C. Prosthetic replacement in femoral neck fracture in the elderly:results and review of the literature. Indian J Orthop. 2008 Jan;42(1):61-7.
[7]Bhandari M, Devereaux PJ, Tornetta P 3rd, et al. Operative management of displaced femoral neck fractures in elderly patients:an international survey. J Bone Joint Surg[Am] 2005;87-A:2122-30.
[8]Iorio R, Schwartz B, Macaulay W, et al. Surgical treatment of displaced femoral neck fractures in the elderly:a survey of the American Association of Hip and Knee Surgeons. J Arthroplasty 2006;21(8):1124-33.
[9]Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty:an end-result study using a new method of result evaluation. J Bone Joint Surg[Am] 1969;51-A:737-55.
[10]温荣彬,施国强,严昌琬.80岁以上患者人工股骨头置换术[J].中华创伤杂志,1995;(6):59-60.
[11]郝林杰,邱裕生,张育民,等.全髋与半髋置换术治疗老年人股骨颈骨折疗效比较[J].实用骨科杂志,2017,23(2):118-123.
[12]刘剑伟,蒋卫平.全髋置换术与半髋置换术治疗股骨颈骨折的疗效对比[J].实用骨科杂志, 2013,19(8):747-749.
[13]王宏伟孟昭宇吴超.人工股骨头置换术与全髋关节置换术治疗老年人股骨颈骨折的临床对比研究[J].医学综述,2015,(18):3447-3448.