人工股骨头置换术与空心加压螺钉固定治疗老年股骨颈骨折的疗效比较

目的:探讨人工股骨头置换术与空心加压螺钉固定治疗老年股骨颈骨折的临床疗效。方法:选取2013年2月到2016年2月在我院接受治疗的老年股骨颈骨折患者50例,采用空心加压螺钉固定治疗的25例患者记为对照组,采用人工股骨头置换术治疗的25例患者记为观察组,对比两组患者的卧床时间、手术时间、术中出血量、再手术率、术后并发症发生率,治疗后随访3个月,对比两组患者的髋关节功能优良率。结果:观察组的术中出血量、手术时间显著高于对照组,卧床时间显著低于对照组,差异有统计学意义(P0.05),观察组的再手术率低于对照组,但差异无统计学意义(P0.05)。观察组术后总并发症发生率为8.00%(2/25),显著低于对照组的32.00%(8/25),差异有统计学意义(P0.05),观察组治疗后3个月髋关节功能优良率为88.00%(22/25),高于对照组的72.00%(18/25),但差异无统计学意义(P0.05)。结论:人工股骨头置换术和空心加压螺钉固定均能较好的治疗老年股骨颈骨折,前者手术时间长、术中出血量多,但卧床时间和总并发症发生率更少,临床上可根据患者的病情和身体状况来选择合适的手术方式。

Femoral Neck Fractures in Elderly Patients: Comparison of Curative Effect of Artificial Femoral Head Replacement and Cannulated Compression Screw Fixation

ABSTRACT Objective: To explore the curative effect of artificial femoral head replacement and cannulated compression screw fixation in the treatment of femoral neck fractures in elderly patients. Methods: A total of 50 elderly patients with femoral neck fracture, who were treated in Yijishan Hospital of Wannan Medical College from February 2013 to February 2016, were selected. 25 patients were treated with cannulated compression screw fixation as control group; 25 patients, with artificial femoral head replacement as observation group. The bed time, operation time,intraoperative blood loss, reoperation rate, postoperative complications of the two groups were compared. The patients were followed up for 3 months after treatment, the excellent and good rates of hip function in the two groups were compared. Results: The operation time and intraoperative blood loss in the observation group were significantly higher than those in the control group, the bed time in the observation group was significantly shorter than that in the control group, the difference was statistically significant (P<0.05). The reoperation rate of the observation group was lower than that of the control group, the difference was not statistically significant(P>0.05). The incidence of postoperative complications in the observation group 8.00%(2/25) ] was significantly lower than that in the control group 32.00%(8/25)], the difference was statistically significant (x2=4.500, P=0.034). The excellent and good rate 88.00%(22/25) ] of hip function in the observation group was higher than that72.00%(18/25)] in the control group 3 months after operation, the difference was not statistically significant (x²=2.000, P=0.157). Conclusion: Both artificial femoral head replacement and cannulated compression screw fixation in the treatment of elderly patients with femoral neck fractures have good clinical efficacy; the operation time of the former is longer, the amount of intraoperative bleeding of the former is more, but the bed time and the incidence of complications are less. So the appropriate operation mode can be chosen by the patient''s condition and physical condition.