全髋关节置换术与半髋关节置换术治疗股骨颈骨折的疗效比较

李俊

（商洛市商州区人民医院，陕西 商洛，726000）

浏览次数：103次 下载次数：389次

摘要：

目的 探讨全髋关节置换术与半髋关节置换术治疗股骨颈骨折的临床疗效。方法 选择2012 年2 月至2017 年2 月在我 院诊治的股骨颈骨折患者70 例，根据随机信封抽签原则分观察组与对照组，各35 例。所有患者在入院10 d 内实施手术。观 察组给予半髋关节置换术，对照组给予全髋关节置换术。比较两组的预后情况。结果 所有患者均顺利完成手术。与对照组 相比，观察组患者的置换时间、出血量、引流量及开始活动时间均明显更优（P<0.05）。术后1 个月两组均无死亡发生，对照组 的并发症总发生率为5.71%，观察组并发症总发生率为8.57%，对照组的并发症总发生率低于观察组，但组间差异不显著（P> 0.05），经对症治疗后均明显好转。结论 半髋关节置换术治疗股骨颈骨折具有创伤小、患者恢复快等优点，全髋关节置换术能 减少术后并发症的发生，临床治疗中需根据患者的具体情况及患者的并发症情况选择合理的手术方式。

关键词：全髋关节置换术；半髋关节置换术；股骨颈骨折

中图分类号：R687.4文献标志码：A文章编号：2096-1413(2018)03-0077-02

Curative effects comparison of replacement of total hip and hemiarthroplasty in the treatment of femoral neck fracture
LI Jun
(the People``s Hospital of Shangzhou District, Shangluo 726000, China)

ABSTRACT: Objective To explore the clinical effect of replacement of total hip and hemiarthroplasty in the treatment of femoral neck fracture. Methods A total of 70 patients with femoral neck fractures in our hospital from February 2012 to February 2017 were selected and divided into observation group and control group with random envelope method, with 35 cases in each group. All patients underwent surgeries within 10 d after admission. The observation group received hemiarthroplasty, and the control group received replacement of total hip. The prognosis of the two groups was compared. Results All surgeries were successfully performed. Compared with the control group, the replacement time, the amount of bleeding, the amount of drainage and the start time in the observation group were significantly better (P<0.05). No death occurred in either group within 1 month after the surgery. The total incidences of complication rate of the control group was 5.71%, while the observation group was 8.57%, there was no statistical difference between the two groups (P>0.05), and they improved after symptomatic treatment. Conclusion Hemiarthroplasty on femoral neck fractures has the advantages of small trauma and rapid recovery, replacement of total hip can reduce the incidence of postoperative complications. In clinical treatment, a reasonable surgical method should be chosen according to the patients`` specific conditions and the patients`` complications.
KEYWORDS: replacement of total hip; hemiarthroplasty; femoral neck fracture

参考文献：
[1] 李文龙,李阳阳,张海龙,等.腕踝针联合自控镇痛泵治疗全髋关节置换术后髋关节疼痛的临床研究[J].中医正骨,2016,28(10):24-28.
[2] 吴鹏,王博,孔令成,等.强骨饮颗粒联合阿仑膦酸钠维D3 片口服 在原发性骨质疏松性髋部骨折术后抗骨质疏松治疗中的应用[J].中医正骨,2016,28(5):16-19.
[3] 黄道文,胡文浩,魏波,等.骨水泥型人工半髋与全髋关节置换治疗高龄股骨颈骨折的比较[J].中国组织工程研究,2013,17(39):7003-7008.
[4] INNGUL C,HEDBECK CJ,BLOMFELDT R.Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures. A four-year follow-up of a randomised controlled trial[J].Int Orthop,2013,37(12):2457-2464.
[5] 赵明明,蔡一强,丁永利,等.无柄人工全髋关节置换术治疗髋关节 疾患的临床研究[J].中医正骨,2016,28(4):37-41.
[6] 吕战兵,荆波,田利卫,等.晚期股骨头坏死应用微创小切口人工全 髋关节置换术治疗的效果[J].中国实用医刊,2016,13(2):13-14.
[7] 颜斌.骨水泥型人工全髋置换技术的临床疗效分析[J].中国组织工 程研究与临床康复,2010,14(17):3163-3166.
[8] 范义平,陈恩祥,蒋泰媛.半髋与全髋置换术治疗老年股骨颈骨折 的疗效比较[J].中国老年学杂志,2012,32(22):4996-4997.
[9] 何龙,陈秀民,王在斌,等.全髋关节置换术治疗成人髋臼发育不良 的临床研究[J].中医临床研究,2016,8(20):111-113.
[10] 曹旭栋,朱亚亮,王磊.全髋置换与人工双极股骨头置换治疗老年 不稳定型股骨粗隆间骨折的效果比较[J].中外医学研究,2016,14(29):8-10.