远端固定生物型股骨假体与骨水泥型股骨假体行人工髋关节置换治疗高龄股骨转子间骨折的早期临床疗效比较

盛斌　　孙岚

[摘要] 目的 分析遠端固定生物型股骨假体与骨水泥型股骨假体行人工髋关节置换治疗高龄股骨转子间骨折的应用效果。 方法 选取2018年4月至2019年4月我院诊治的68例高龄股骨转子间骨折患者，均给予人工髋关节置换治疗，随机均分为对照组和观察组，每组各34例。对照组应用骨水泥型股骨假体进行远端固定，观察组应用生物型股骨假体进行远端固定，比较两组患者相关手术指标、Harris评分和并发症发生情况。 结果 两组患者术中出血量、住院时间和下床锻炼时间比较，差异均无统计学意义（P>0.05）。观察组手术时间短于对照组，差异有统计学意义（P<0.05）;两组术后1个月、术后6个月和术后12个月Harris评分均高于术前，且呈逐渐上升趋势，但两组比较，差异无统计学意义（P>0.05）;两组假体周围骨折、深静脉血栓和切口感染发生率比较，差异无统计学意义（P>0.05）;观察组心肺事件发生率低于对照组，差异有统计学意义（P<0.05）。 结论 在人工髋关节置换治疗高龄股骨转子间骨折患者过程中，生物型股骨假体与骨水泥型股骨假体远端固定均能取得到显著疗效，但相对比于骨水泥型股骨假体，生物型股骨假体能显著降低手术时间和心肺事件发生率，具有临床推广价值。

[关键词] 远端固定;生物型股骨假体;骨水泥型股骨假体;人工髋关节置换;高龄患者;股骨转子间骨折

[中图分类号] R687.3          [文献标识码] B          [文章编号] 1673-9701（2021）09-0103-03

Comparison of the early clinical effects of distally fixed biological femoral prosthesis and cemented femoral prosthesis for artificial hip replacement in the treatment of elderly femoral intertrochanteric fractures

SHENG Bin   SUN Lan

Department of Orthopedics， Jingzhou Third People′s Hospital in Hubei Province， Jingzhou   434000， China

[Abstract] Objective To analyze the application effect of distally fixed biological femoral prosthesis and cemented femoral prosthesis for artificial hip replacement in the treatment of elderly femoral intertrochanteric fractures. Methods A total of 68 elderly patients with intertrochanteric fractures who were diagnosed and treated in our hospital from April 2018 to April 2019 were selected. All patients were treated with artificial hip replacement. All patients were randomly divided into control group and observation group， 34 cases in each group. The control group was treated with cemented femoral prosthesis for distal fixation， and the observation group was treated with biological femoral prosthesis for distal fixation. The related surgical indicators， Harris scores and complications were compared between the two groups. Results There were no significant differences in intraoperative blood loss， hospitalization time and out of bed exercise time between the two groups（P>0.05）. The operation time of the observation group was shorter than that of the control group， the difference was statistically significant（P<0.05）; The Harris scores at 1 month， 6 months and 12 months after operation in the two groups were higher than those before operation， and gradually increased， but there was no significant difference between the two groups（P>0.05）; There was no significant difference in the incidence of periprosthetic fracture， deep vein thrombosis and incision infection between the two groups（P>0.05）; The incidence of cardiopulmonary events in the observation group was lower than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion In the process of artificial hip replacement in the treatment of elderly patients with femoral intertrochanteric fractures， distal fixation of both biological femoral prostheses and cemented femoral prostheses can achieve significant results. However， compared with cemented femoral prostheses， biological femoral prostheses can significantly reduce the duration of surgery and the incidence of cardiopulmonary events， which has the value of clinical promotion.

[Key words] Distal fixation; Biological femoral prosthesis; Cemented femoral prosthesis; Artificial hip replacement; Elderly patients; Femoral intertrochanteric fractures

股骨转子间骨折是临床上多发的一种骨科疾病，患者在临床上的常见症状有转子区疼痛、下肢活动受限、淤血斑、肿胀、下肢外旋畸形明显等，近年来在我国人口老龄化趋势加重的影响下，该病发生率一直呈上升趋势，严重影响患者的生活质量[1]。人工髋关节置换是现阶段高龄股骨转子间骨折患者主要治疗方式，技术成熟，疗效显著且可靠，其中骨水泥型股骨假体可起到良好的远端固定效果，但术后易使患者发生急性心血管事件，因此选取更安全的远端固定方法具有积极意义，生物型股骨假体可令骨床和假体之间进行直接接触，对患者造成的创伤更小，更有助于患者恢复健康[2]。本研究主……