徐莉敏 刘兴邦

[摘要] 目的 探討两种髋关节置换术（全髋关节置换术和半髋关节置换术）在老年性股骨颈骨折应用的短期效果。方法 回顾分析我院2018年5月至2020 年5月收治的98例老年性股骨颈骨折患者，按照手术方式的不同，分为对照组和观察组，对照组行半髋关节置换术，观察组行全髋关节置换术。比较两组的围手术期情况：切口长度、术中出血量、手术时间、术后出血量、下地活动时间、住院时间，对比随访情况：术后3个月的Harris评分。 结果 对照组患者切口长度为（8.43±2.59）cm，观察组为（9.53±2.84）cm，差异有统计学意义（P<0.05）。对照组患者术中出血量为（98.16±5.34）mL，观察组为（374.2±7.23）mL，差异有统计学意义（P<0.05）。对照组患者手术时间为（41.34±2.26）min，观察组为（92.50±4.66）min，差异有统计学意义（P<0.05）。对照组患者术后出血量为（110.48±5.35）mL，观察组为（657.31±4.48）mL，差异有统计学意义（P<0.05）。对照组患者下地活动时间（1.48±0.50）d，观察组（3.06±0.81）d，差异无统计学意义（P>0.05）。对照组住院时间为（9.98±0.82）d，观察组为（11.00±1.40）d，两组差异无统计学意义（P>0.05）。对照组术后3个月的Harris评分为（78.14±2.12）分，优良率为82.00%;观察组为（78.15±2.07）分，优良率为72.90%;差异均无统计学意义（P>0.05）。 结论 对于老年股骨颈骨折患者，半髋置换术因其术中术后出血少、手术时间短、下地活动时间早从而短期效果优于全髋关节置换术。

[关键词] 全髋关节置换术;半髋关节置换术;老年性;股骨颈骨折;短期效果

[中图分类号] R687.3          [文献标识码] B          [文章编号] 1673-9701（2021）30-0089-04

[Abstract] Objective To investigate and compare the short-term effects of two types of hip arthroplasty（total hip arthroplasty and hip hemiarthroplasty）in the application of elderly femoral neck fractures. Methods A retrospective analysis of 98 elderly patients with femoral neck fractures admitted to our hospital from May 2018 to May 2020 was conducted.They were divided into the control group and the observation group according to different surgical methods.The control group were given hip hemiarthroplasty and the observation group were given total hip arthroplasty.The perioperative conditions of the two groups were compared and analyzed，including incision length，intraoperative blood loss，operation time，postoperative blood loss，time to off-bed activity，and hospital stay.Harris score at 3 months after operation was used to compare follow-up conditions. Results The incision length was（8.43±2.59）cm in the control group and（9.53±2.84）cm in the observation group，with statistically significant difference（P<0.05）.The intraoperative blood loss in the control group was（98.16±5.34）mL，and（374.2±7.23）mL in the observation group，with statistically significant difference（P<0.05）.The operation time in the control group was（41.34±2.26）min，and（92.50±4.66）min in the observation group，with statistically significant difference（P<0.05）.The postoperative blood loss in the control group was（110.48±5.35）mL，and（657.31±4.48）mL in the observation group，with statistically significant difference（P<0.05）.The time to off-bed activity was（3.06±0.81）d in the control group，and（1.48±0.50）d in the observation group，without statistically significant difference（P>0.05）.The hospital stay in the control group was（9.98±0.82）d，and（11.00±1.40）d in the observation group was，without statistically significant difference（P>0.05）.The Harris score at 3 months after operation was （78.14±2.12）points in the control group，with an excellent and good rate of 82.00%，and 78.15±2.07 in the observation group，with an excellent and good rate of 72.90%，without statistically significant differences（P>0.05）. Conclusion Elderly patients with femoral neck fractures usually have poor general conditions.Hip hemiarthroplasty has less intraoperative blood loss，shorter operation time and earlier time to off-bed activity，which is better than total hip replacement.Hip hemiarthroplasty has better short-term effect than total hip replacement.

[Key words] Total hip arthroplasty;Hip hemiarthroplasty;Elderly;Femoral neck fracture;Short-term effect

随着中国进入老年化社会，老年患者特别是高龄患者逐渐增多。髋部骨折对于人体的伤害较大，最常见的是股骨颈骨折，且后者发病率呈逐渐增长的趋势[1-6]。……