人工股骨头置换术和全髋关节置换术治疗老年股骨颈骨折的疗效及对生活质量的影响对比

李国兴

[摘要] 目的 探討两种不同术式治疗老年股骨颈骨折的临床疗效及对生活质量的影响。 方法 方便选取该院2012年9月—2017年9月期间收治的108例老年股骨颈骨折患者作为研究对象，将全部入选者随机分为研究组、对照组，均为54例。采用全髋关节置换术（THA）对对照组患者进行治疗，采用人工股骨头置换术（BA）对研究组患者进行治疗，并将两组手术相关指标、术后并发症发生率进行对比，另外，将两组术前、术后QOL评分进行对比。结果 研究组平均手术时间、术中出血量、术后引流量、术后住院时间分别为（80.79±5.64）min、（216.53±17.25）mL、（191.35±8.72）mL、（13.57±2.12）d，均明显低于对照组的（146.32±7.59）min、（439.63±29.68）mL、（314.97±9.29）mL、（19.35±3.68）d（P<0.05）；研究组术后未出现1例并发症，对照组术后共3例患者出现假体脱位，并发症发生率为5.56%（χ2=5.719、P=0.017）；术前两组QOL评分差异无统计学意义，术后对照组QOL评分较研究组明显更高（t=0.301、P=0.764、t=6.382、P=0.000）。结论 THA、BA各有优劣势，在临床实际工作中，应根据患者实际情况进行综合分析，选择更为合适的手术方式进行治疗，降低术后各类并发症发生率，进一步增强手术效果，促进术后康复。

[关键词] THA；BA；老年股骨颈骨折；疗效；生活质量

[中图分类号] R687 [文献标识码] A [文章编号] 1674-0742（2018）05（a）-0081-03

Comparison of Curative Effect of Artificial Femoral Head Replacement and Replacement of Total Hip in Treatment of Senile Transcervical Fracture and Effect on the Quality of Life

LI Guo-xing

Department of Orthopedics， Luoding Peoples Hospital， Luoding， Guangdong Province， 527200 China

[Abstract] Objective To study the curative effect of artificial femoral head replacement and replacement of total hip in treatment of senile transcervical fracture and effect on the quality of life. Methods 108 cases of senile transcervical fracture patients admitted and treated in our hospital from September 2012 to September 2017 were convenient selected and randomly divided into two groups with 54 cases in each， the control group and the research group were respectively treated with THA and BA， and the operation related indicators， and incidence rate of complications after surgery were compared between the two groups， besides， the QOL scores before and after surgery were compared between the two groups. Results The average operation time， intraoperative bleeding amount， postoperative drainage volume and postoperative length of stay in the research group were obviously lower than those in the control group， [（80.79±5.64）min， （216.53±17.25）mL， （191.35±8.72）mL，（13.57±2.12） d vs （146.32±7.59）min，（439.63±29.68）mL，（314.97±9.29）mL，（19.35±3.68）d]（P<0.05）， and there was 1 case with complications in the research group and 3 cases with Prosthesis dislocation in the control group after surgery， and the incidence rate of complications was 5.56%（χ2=5.719， P=0.017） ， and there was no obvious difference in the QOL score between the two groups before surgery， and the QOL score in the control group after surgery was obviously higher than that in the control group （t=0.301， P=0.764， t=6.382， P=0.000） . Conclusion The THA and BA have advantages and disadvantages， and in the clinical practical work， we should select the proper operation way for treatment according to the practical conditions， thus reducing the incidence rate of various complications and further enhancing the operative effect， promoting the recovery after surgery.

[Key words] THA； BA； Senile transcervical fracture； Curative effect； Quality of life

股骨颈骨折以中老年人较常见，主要是指股骨头至股骨颈基底部所发生的骨折，在全部骨折中约占3.58%[1]。近年来随着人口逐渐老龄化，老年股骨颈骨折在临床上发生率逐年攀升，给老年患者带来较大痛苦，同时对其身心健康造成严重危害，降低患者生活质量。股骨颈骨折处理不当可导致股骨头发生缺血性坏死，加上患者长期卧床易导致压疮的形成。当前临床主要通过手术治疗的方式对老年股骨颈骨折患者进行治疗，内固定术、BA、THA均是临床常用治疗手段，不同治疗方式的优点及缺点也不同[2-3]。为进一步提升手术疗效，改善患者生活质量，该文方便选取该院2012年9月—2017年9月期间收治的108例老年股骨颈骨折患者作为研究对象，将全部入选者随机分为研究组、对照组，均为54例。……