老年不稳定股骨粗隆间骨折行双极人工股骨头置换治疗的疗效分析

目的：探讨双极人工股骨头置换在高龄不稳定股骨粗隆间骨折中的疗效。方法：125例患者随机分为两组，观察组采用双极人工股骨头置换术治疗，对照组采用动力髋螺钉内固定术，比较两Harris疗效和手术时间、失血量、下地时间、再手术率和并发症等。结果：观察组手术时间大于对照组，失血量和下地时间小于对照组，差异均具有统计学意义（P〈0．05）；观察组优良率82．54％，对照组优良率66．13％，两组优良率差异有统计学意义（Riditz=11．574，P=0．000）；对照组共发生并发症15例（24．19％），再手术率6．45％，观察组出现并发症3例（4．76％），无再手术患者，两组并发症发生率和再手术率有统计学意义（Fisher P〈0．05）。结论：对老年不稳定股骨粗隆间骨折行双极人工股骨头置换治疗疗效显著，值得临床推广应用。

The Clinical Effect of Bipolar Prosthetic Replacement for Femoral Neck Fractures in Elderly

Objective： To explore the clinical effect of bipolar prosthetic replacement for femoral neck fractures in old people. Methods： 125 cases were divided into 2 groups randomly, test group was treated by bipolar prosthetic replacement, and control group was treated by dynamic hip screw fixation. The Harris effect, blood loss, operation time, shimoji time, reoperation rate and complications of two groups was compared. Results： Operation time in test group was greater than that of control group, blood loss and shimoji time were lower than those of control group, the difference were statistically significance （P〈0.05）; the excellent rate was 82.54% in test group, 66.13% in the control group, there was significant difference in two groups （Ridit z=l 1.574, P=0.000）; complication rate in test group was 4.76% in test group, no reoperation cases, 24.19% complication rate and 6.45% reoperation rate in control group and, there were sig- n ificant difference in two groups （Fisher P〈0.05）. Conclusions： bipolar prosthetic replacement for femoral neck fractures in elderly people had significantly efficient and was worthy of application in clinical.