Objective To analyzed the impact of hip replacement on the pain degree and joint function in elderly patients with femoral neck fracture.Methods 106 elderly patients with femoral neck fracture were divided into an observation group and a control group,53 for each group.The observation group were treated with hip prosthesis replacement and the control group closed reduction and internal fixation.The surgical state,pain degree,and joint function were compared between these two groups.Results The time to get off bed was obviously shorter and the intra-operative bleeding volume was much less in the observation group than in the operation group [(12.34±2.14) d vs.(20.12±3.24) d and (35.65±4.32) ml vs.(70.32±7.35)ml] (t=14.587 ～ 29.605,P＜0.01).The VAS scores were markedly lower in the observation group than in the control group 1 and 3 days after the operation [(4.61±0.33) vs.(5.16±0.35) and (6.52±0.58) vs.(7.64±0.82)](t=7.654～8.324,P＜0.05).The Harris scores was significantly higher in the observation group than in the control group 3 and 24 months after the operation [(71.82±7.34) vs.(60.33±6.56) and (94.35± 10.05) vs.(83.79±9.16)](t=5.670～8.479,P＜0.05).The incidence of complications and re-operation rate were significantly lower and the treatment cost was significantly higher in the observation group than in the control group [7.55％ vs.26.42％ and 5.66％ vs.7.55％ and (38 945.35±3872.81) yuan vs.(21 873.79±2436.16) yuan](t/x 2=6.291～17.167,P＜0.05,P＜0.01).Conclusions Hip replacement can effectively alleviate the patients' pain,lower the incidence of complications,and improve the hip joint function,but its cost is significantly higher internal fixation's.%目的 分析髋关节置换对老年股骨颈骨折患者疼痛程度及关节功能的影响.方法 选择106例老年股骨颈骨折移位型患者为研究对象,采用随机数字表法分为观察组和对照组,各53例.观察组行髋关节假体置换术,对照组行闭合复位内固定术,比较两组手术情况、疼痛程度、关节功能、并发症及治疗费用.结果 手术情况:观察组下地时间、术中出血量均明显低于对照组[(12.34±2.14) dvs(20.12±3.24)d,(35.65±4.32) ml vs(70.32±7.35) ml],t=14.587 ～ 29.605,P＜0.01;疼痛程度:术后1d、3d观察组VAS评分均明显低于对照组[(4.61 ±0.33)vs(5.16±0.35),(6.52±0.58)vs(7.64±0.82)],t=7.654 ～ 8.324,P＜0.05;关节功能:术后3个月、24个月观察组Harris评分明显高于对照组[(71.82±7.34)vs(60.33±6.56);(94.35±10.05)vs(83.79±9.16),t=5.670 ～ 8.479,P＜0.05;并发症及治疗费用:观察组并发症、再手术率均明显低于对照组(7.55％ vs 26.42％,5.66％ vs 22.64％),治疗费用明显高于对照组[(38945.35±3872.81)元vs(21873.79±2436.16)元],t/x2=6.291 ～ 17.167,P＜0.05,P＜0.01.结论 髋关节置换术能有效减轻老年髋部骨折患者疼痛程度,降低并发症,提高髋关节功能,但治疗费用明显高于内固定术.
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