双动股骨头置换术和髋关节置换术治疗股骨颈骨折的综合比较

摘要

目的:比较双动股骨头置换术和髋关节置换术治疗股骨颈骨折动力的临床疗效. 方法:选取本院2012年3月至2014年1月收治的78例股骨颈骨折患者作为研究对象,其中38例行双动股骨头置换术(观察组),40 例行髋关节置换术(对照组),对比分析两种术式的手术情况、愈合情况、Harris髋关节功能评分及术后并发症等指标. 结果:观察组平均手术时间为(79.74±12.65)min,对照组平均手术时间为(96.45±21.75)min,两组比较,观察组手术时间较对照组明显缩短. 同时观察组术中出血量与引流量亦明显于对照组,差异有统计学意义( P<0.05). 观察组术后第1天主动直腿抬高的角度明显大于对照组,且完全负重所需周数与骨折愈合周数均明显低于对照组. 术后1周与6周,观察组患者Harris评分均高于对照组,差异有统计学意义( P<0.05). 但术后3个月后,两组患者评分结果基本一致,表明两组患者的远期疗效差异不显著( P>0.05). 同时,观察组并发症发生率明显高于对照组( P<0.05). 结论:双动股骨头置换术与髋关节置换术均是治疗股骨颈骨折的良好手术方法,临床实践中,应坚持个体化治疗的原则,对患者进行正确的评估,采用合适的手术方法,使治疗取得满意的疗效.%Objective:To investigate the clinical efficacy of bipolar femoral head replacement and total hip replacement on the treatment of femoral neck fractures.Method: We retrospectively studied 78 cases with femoral neck fractures from March 2012 to January 2014 in our hospital,which were divided into the ob-servation group and control group,38 cases with bipolar femoral head replacement,while 40 cases with total hip replacement.And compared the operation time,healing time, Harris hip score and the postoperative com-plications of two groups.Result:The average operation time of observation group was (79.74 ±12.65) min, while the control group was (96.45±21.75) min, comparing the two groups, the operation time of observa-tion group was significantly shortened.At the same time, bleeding amount of observation group was also ap-parent decreased in the control group, the difference was statistically significant( P<0 .05) .The active angle of the observation group after one day was significantly greater than the control group, and the healing weeks were significantly lower than the control group.After 1 week and 6 weeks, Harris scores in patients with ob-servation group was higher than that of control group, the difference was statistically significant ( P<0.05) . But three months later, two groups showed the same score, which was no significant difference in the curative effect ( P>0.05) .At the same time, the complication rate of observation group was significantly higher than the control group (P<0.05).Conclusion:Bipolar femoral head replacement and total hip replacement are both good surgery method for treatment of femoral neck fractures.We should stick to the principle of individu-alized treatment, which is adopted the appropriate surgical method to obtain satisfactory curative effect.