张华杰　刘昶　王秉文

[摘要] 目的 比较全髋关节置换术与内固定术在老年股骨颈骨折治疗中的临床效果。 方法 将2014年10月～2016年5月间在我院接受诊治的85例老年股骨颈骨折患者进行研究；根据患者入院单双日时间将85例患者分为观察组（n=44）和对照组（n=41）；分别对两组患者实施全髋关节置换术和常规内固定术并比较治疗效果。 结果 手术时间、术中失血量两项指标比较，对照组的优势更为明显；但术后下地时间、并发症发生率、关节功能优良率及患者生活质量评分和满意度比较，观察组均优于对照组（P<0.05）。 结论 在老年股骨颈骨折患者的治疗中，全髋关节置换术较传统内固定术能够更好的恢复患者的关节功能、控制术后并发症进而提升患者的生活质量，方法经过对比研究效果确切，值得在临床实践中借鉴并给予相应的推广。

[关键词] 老年股骨颈骨折；全髋关节置换术；内固定术；关节功能；并发症

[中图分类号] R683.42 [文献标识码] B [文章编号] 1673-9701（2017）19-0066-03

[Abstract] Objective To compare the clinical effects of total hip arthroplasty and internal fixation in the treatment of elderly patients with femoral neck fracture. Methods 85 elderly patients with femoral neck fracture in our hospital from October 2014 to May 2016 were enrolled. The patients were divided into observation group（n=44）and control group（n=41） according to the single and double day when patient were admitted.The patients in the two groups underwent total hip arthroplasty and conventional internal fixation respectively， and the therapeutic effect was compared. Results The control group's advantage in the operation time and intraoperative blood loss was more obvious. However， the time of going down to ground， the incidence of complications， the excellent rate of joint function， the quality of life and satisfaction of the observation group were better than those of the control group（P<0.05）. Conclusion In the treatment of elderly patients with femoral neck fracture， total hip arthroplasty can restore the joint function of the patients，control the postoperative complications and improve the quality of life of the patients better， compared with the traditional internal fixation. The method has the exact effect through comparative study， and is worthy of reference and promotion in clinical practice.

[Key words] Elderly patients with femoral neck fracture；Total hip arthroplasty；Internal fixation；Joint function；Complication

股骨頸骨折指的是股骨颈头颈交界处至股骨颈基底部的骨折，属于临床上常见的骨折类型，约占全身骨折的3%～4%[1]；由于老年人的关节稳定性相对较差，加上骨质疏松的影响，因而是该疾病的主要人群。传统的保守治疗虽然理论上能够取得一定的效果，但长时间的卧床会增加各类并发症的发生，严重时还将直接危及患者的生命安全[2]；因此，一般情况下建议患者接受手术治疗，而内固定术和全髋关节置换术均是临床上使用率较高的两种术式，为探讨最佳治疗方法，提升治疗效果，本研究将以接收的患者进行分组研究，对两种方法的临床效果进行全面的探讨，现报道如下。

1 资料与方法

1.1 一般资料

将2014年10月～2016年5月在我院接受诊治的85例老年股骨颈骨折患者展开研究；……