全髋关节置换与双极人工股骨头治疗老年股骨头缺血性坏死的效果比较

摘要

Objective:To explore the elderly femoral head avascular necrosis(Avscular Necrosis of the Femoral Head,ANFH)for total hip arthroplasty(THA)and the clinical therapeutic effect of bipolar artificial femoral head replacement,and provide theoretical basis for clinical treatment. Method:112 cases of senile ischemic necrosis of femoral head of clinical treatment were analyzed retrospectively from January 2008 to March 2013, according to the condition divided the patients into two groups:group A with total hip replacement in treatment,group B used bipolar artificial femoral head treatment,compared two groups of patients with operation time,intraoperative blood loss,postoperative recovery down time differences. Result:Can be engaged in activities postoperatively in patients with group A was shorter than group B,group B operation time and blood loss was significantly lower than that of group A(P<0.05),group B was A bipolar artificial femoral head replacement was in A good treatment effect,by X-ray examination,necrosis of joint prosthesis position without displacement,dislocation phenomenon,did not appear more serious infection,compared the results with statistical soft for processing. Conclusion:Clinical use of artificial femoral head replacement and total hip replacement has good curative effect for treatment of the elderly ischemic necrosis,from the consideration on the long-term curative effect of total hip replacement is better than a bipolar artificial femoral head replacement,but need to comprehensive analysis on the basis of the condition of the patients with the most appropriate treatment and guide clinical treatment.%目的：探讨分析老年人股骨头缺血性坏死（Avascular Necrosis of the Femo al Head ，ANFH）进行全髋关节置换术（THA）与双极人工股骨头置换术的临床治疗效果，并为临床治疗提供理论依据。方法：回顾性分析本院自2008年1月-2013年3月接收诊治的112例老年股骨头缺血性坏死临床治疗情况，将患者随机分为两组，A组采用全髋关节置换用术进行治疗，B组采用双极人工股骨头法治疗，比较两组患者手术时间、术中出血量、术后恢复可下地时间等指标。结果：A组患者术后可下地活动时间短于B组，B组手术时间和出血量显著低于A组（P<0.05），B组即双极人工股骨头置换术的整体治疗效果较好，经X线检查，坏死关节假体位置无位移、错位现象，未出现较严重感染，比较结果用统计学软进行处理。结论：临床采用全髋关节置换术和人工股骨头置换术对于治疗老年人股骨头缺血性坏死具有较好疗效，全髋关节置换术从长远上考虑全髋关节置换术优于双极人工股骨头置换术疗效，但需根据患者具体情况综合性分析最恰当治疗方式，指导临床治疗。