人工全髋关节置换术辅以药物治疗股骨颈骨折合并2型糖尿病患者的临床效果

摘要

目的：探讨人工全髋关节置换术辅以药物治疗股骨颈骨折合并2型糖尿病患者的临床效果。方法将徐州医学院附属医院脊柱外科于2013年3月~2014年9月收治的72例股骨颈骨折合并2型糖尿病患者随机分为观察组(36例)和对照组(36例)，观察组采用人工全髋关节置换术联合药物治疗，对照组采用人工全髋关节置换术治疗，比较两组疼痛程度、髋关节功能、生活质量、并发症发生情况。结果观察组术后视觉模拟评分为(2.3±0.8)分，低于对照组的(5.8±1.0)分，差异有高度统计学意义(P<0.01)。与术前比较，两组术后Barthel指数评分均升高，差异有统计学意义(P<0.05)；观察组术后各时间段Barthel指数评分高于对照组，差异有高度统计学意义(P<0.01)。观察组优良率为91.7%(33/36)，高于对照组的69.4%(25/36)，差异有统计学意义(P<0.05)。两组术后深静脉血栓、异位骨化及假体松动发生率比较，差异有统计学意义(P<0.05)。结论人工全髋关节置换术联合药物治疗股骨颈骨折合并2型糖尿病患者可促进髋关节功能恢复，并减少并发症发生，可在临床上推广。%Objective To explore clinical effect of total hip arthroplasty complementary with drug in the treatment of patients with femoral neck fracture combined with type 2 diabetes. Methods 72 patients with femoral neck fracture combined with type 2 diabetes in Department of Spinal Surgery Affiliated Hospital of Xuzhou Medical College from March 2013 to September 2014 were selected and randomly divided into observation group (36 cases) and control group (36 cases). Observation group was treated with total hip arthroplasty complementary with drug treatment, control group accepted the treatment of total hip arthroplasty. The degree of pain, function of hip joint, quality of life, occurrence of complication after operation between two groups were compared. Results The postoperative VAS of observation group was (2.3±0.8) points, lower than that of control group [(5.8±1.0) points], with statistically significant difference (P<0.01). Compared with the preoperative, Barthel index scores of two groups were all increased, with statistical differences (P<0.05). Barthel scores at different moments of observation group were higher than those of control group, with statis-tically significant differences (P<0.01). The excellent and good rate of observation group was 91.7%(33/36), higher than that of control group [69.4% (25/36)], with statistical difference (P<0.05). The incidence rate of deep venous thrombo-sis, heterotopic ossification and prosthesis loosening between two groups were compared, with statistical differences (P<0.05). Conclusion Total hip arthroplasty complementary with drug in the treatment of patients with femoral neck frac-ture combined with type 2 diabetes can promote recovery of hip joint function and reduce occurrence of complication, which can be applied in clinical practice.