全髖關節置換術與人工股骨頭置換術治療老年新鮮股骨頸骨折的對比研究

王鋒 張偉 房玉利

[摘要] 目的 比較全髖關節置換術與人工股骨頭置換術治療老年新鮮股骨頸骨折的手術效果及并發癥情況。 方法 選擇我院2012年12月～2013年12月接受人工關節置換的老年股骨頸骨折患者60例，全部患者根據治療方法不同分成A組（全髖關節置換術）和B組（人工股骨頭置換術），每組30例，觀察并比較兩組患者的手術時間、出血量、術后1年Harris評分、術后髖關節功能的優良率及并發癥情況。 結果 A組行全髖關節置換術患者的手術時間較長、術中出血量較多，但術后1年的Harris評分顯著高于B組（P<0.01或P<0.05）。術后隨訪1年，A組患者術后髖關節功能的優良率達86.7%，B組患者術后髖關節功能的優良率達73.3%，兩組比較差異具有統計學意義（χ2=4.736，P<0.05）。 結論 全髖關節置換術與人工股骨頭置換術均為治療老年新鮮股骨頸骨折有效的治療方法，與人工股骨頭置換術相比，全髖關節置換術手術效果更好，且并發癥發生率低。

[關鍵詞] 全髖關節置換術；人工股骨頭置換術；老年；股骨頸骨折；并發癥

[中圖分類號] R687.3 [文獻標識碼] B [文章編號] 1673-9701（2015）12-0034-03

Total hip arthroplasty and hemiarthroplasty comparative study in treatment of fresh femoral neck fracture in aged patients

WANG Feng ZHANG Wei FANG Yuli

Department of Orthopaedic 9， the Fifth Hospital of Harbin City， Harbin 150040， China

[Abstract] Objective To compare effect and complications of total hip replacement and artificial femoral head replacement in treatment of fresh femoral neck fracture in old people. Methods All 60 cases of elderly patients with femoral neck fracture of our hospital from December 2012 to December 2013 who accepted the artificial joint replacement， all the patients according to the different treatment methods were divided into group A（total hip replacement） and group B（artificial femoral head replacement）， with 30 cases in each group， the operation time， the amount of bleeding， postoperative 1 years Harris score， postoperative hip joint function of the excellent and good rate and complications were observed and compared. Results The time of operation in group A underwent total hip arthroplasty in patients with longer， intraoperative bleeding more， but after 1 years of Harris scores were significantly higher than those in group B （P<0.01 or P<0.05）. After 1 years follow-up， the excellent rate of hip joint function in patients after group A was 86.7%， the excellent rate of hip joint function in patients after B group was 73.3%， in two groups with statistically significant difference（χ2=4.736， P<0.05）. Conclusion Total hip replacement and artificial femoral head replacement is an effective method for the treatment of fresh femoral neck fractures in the elderly patients， compared with artificial femoral head replacement， the total hip arthroplasty surgery has better effects and lower complication rate.

[Key words] Total hip replacement； Artificial femoral head replacement； Elderly； Femoral neck fracture； Complication