全髋关节置换与双极人工股骨头置换治疗老年股骨颈骨折临床疗效对比研究

摘要

Objective To explore the clinical effects of total hip replacement (THR)and bipolar femoral head replacement (BFHR)on treatment of elderly patients with femoral neck frac-ture.Methods 74 elderly patients with femoral neck fracture were randomly devided into observa-tion group and control group.The observation group was treated with THR,while the control group was treated with BFHR.Clinical efficacy was compared between the two groups.Results The operating time of the observation group was significantly longer than the control group(P <0. 01),and amounts of blood loss and postoperative drainage were significantly larger than the control group(P <0.01).3 years after operation,Harris score of the observation group was significantly higher than the control group (P <0.05),and there was no significant difference of postoperative complications between two groups (P >0.05).Conclusion Both THR and BFHR can treat femoral neck fracture effectivel.In the clinic,choice of therapies should be carefully considered on the basis of comprehensive factors such as age,physical condition and expected survival time.%目的：探讨全髋关节置换（THR）与双极人工股骨头置换（FHR）在老年股骨颈骨折中的应用效果。方法74例老年股骨颈骨折患者随机分为观察组与对照组每组37例，观察组给予 THR 治疗，对照组给予 FHR 治疗，对比两组疗效。结果观察组手术时间显著长于对照组（P ＜0．01），术中出血量及术后引流量显著多于对照组（P ＜0．01），术后1年两组 Har-ris 评分及优良率比较无统计学差异（P ＞0．05），术后3年观察组 Harris 评分及优良率均显著高于对照组（P ＜0．05），两组术后并发症发生率无统计学差异（P ＞0．05）。结论 THR 与 FHR 在老年股骨颈骨折的治疗中均具有较为满意的效果，但在临床实践中仍需密切结合患者年龄、身体状况、预期生存时间等多种因素综合进行选择。