熊军委 李怀强 谭娟

[摘要]目的 探讨人工双极股骨头置换术（BFHR）治疗老年移位型股骨颈骨折的近期疗效以及术后康复方式。方法 选取2017年8月～2018年12月我院收治的80例移位型股骨颈骨折患者作为研究对象，按照随机数字表法将其分为对照组（40例）与观察组（40例）。两组患者均行BFHR治疗，对照组患者采用行常规干预方法，观察组患者采用早期康复训练方法。比较两组患者的手术指标、髋关节功能、生活质量、并发症总发生率。结果 两组患者的手术时间、术中出血量、术后引流、住院时间、下床行走时间比较，差异无统计学意义（P>0.05）;观察组患者术后12个月的Harris评分高于对照组，差异有统计学意义（P<0.05）;两组患者术后12个月的Harris评分均低于术后6个月，差异有统计学意义（P<0.05）;观察组患者的生理功能、生理受限、躯体疼痛、情感角色、社会功能和总体健康评分高于对照组，差异均有统计学意义（P<0.05）;观察组患者的术后并发症总发生率低于对照组，差异有统计学意义（P<0.05）。结论 BFHR治疗老年移位型股骨颈骨折的近期恢复效果较好，且进行早期康复训练利于患者髋关节功能恢复，提高生活质量，且并发症发生率较低，值得临床应用推广。

[关键词]股骨颈骨折;人工双极股骨头置换术;康复;髋关节功能;生活质量;并发症

[中图分类号] R683.42          [文獻标识码] A          [文章编号] 1674-4721（2020）7（c）-0082-04

Analysis of short-term efficacy and discussion on postoperative rehabilitation methods of artificial bipolar femoral head replacement in treatment of senile femoral neck fracture

XIONG Jun-wei   LI Huai-qiang   TAN Juan

The First Department of Orthopedics， Jingdezhen First People′s Hospital， Jiangxi Province， Jingdezhen   333000， China

[Abstract] Objective To investigate the short-term efficacy and its postoperative rehabilitation methods of artificial bipolar femoral head replacement （BFHR） in the treatment of senile femoral neck fracture. Methods A total of 80 patients with displaced femoral neck fracture who admitted in the hospital from August 2017 to December 2018 were selected as the research objects， and they were divided into control group （40 cases） and observation group （40 cases） according to the random number table method. Two groups were treated with BFHR， control group was given routine nursing， and observation group was given early rehabilitation training. The surgical indexes， hip joint function， quality of life， and the total incidence of complications were compared between two groups. Results There were no statistically significant differences between the two groups in operation time， intraoperative blood loss， postoperative drainage， length of hospital stay， and off-bed walking time （P>0.05）. Twelve months after surgery， the Harris score in the observation group was higher than that in the control group， and the difference was statistically significant （P<0.05）. Harris scores in both groups at 12 months after surgery were lower than those at 6 months after surgery， and the differences were statistically significant （P<0.05）. The scores of physiological function， physiological limitation， physical pain， role emotional， social function and general health in observation group were higher than those in the control group， and the differences were statistically significant （P<0.05）. The total incidence of postoperative complications in observation group was lower than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion BFHR in treatment of senile displaced femoral neck fracture has better short-term recovery effect. Early rehabilitation training can promote recovery of hip joint function， improve quality of life and have lower incidence of complications. It is worth popularizing in clinical application.

[Key words] Femoral neck fracture; Artificial bipolar femoral head replacement; Rehabilitation; Hip joint function; Quality of life; Complications

股骨颈骨折是临床多发于老年人群的骨折类型，随着人口老龄化的加剧，发病率呈逐年上升趋势[1-2]。老年人特殊的体质是股骨颈骨折的高发人群，多伴有骨质疏松，易跌倒，造成股骨颈骨折。有关研究指出，股骨颈骨折患者应采取及时有效的治疗措施，将患者的股骨颈错位程度恢复，改善患者的髋关节功能[3]。而人工双极股骨头置换术（BFHR）是临床治疗股骨颈骨折的常用手术，并取得一定的疗效，但老年患者的身体情况较差，术后康复较为缓慢，故采取有效的术后康复护理极为重要[4]。鉴于此，本研究选取我院收治的80例移位型股骨颈骨折患者作为研究对象，旨在探讨BFHR治疗老年移位型股骨颈骨折的近期疗效以及术后康复方式，现报道如下。