中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2014年
12期
1820-1822
,共3页
股骨颈骨折%关节成形术,置换,髋%股骨头%人工关节
股骨頸骨摺%關節成形術,置換,髖%股骨頭%人工關節
고골경골절%관절성형술,치환,관%고골두%인공관절
Femoral neck fracture%Arthroplasty,replacement,hip%Femur head%Joint prosthesis
目的 比较全髋关节置换与人工股骨头置换治疗老年人股骨颈骨折的疗效.方法 62例采用保守治疗或钢板内固定失败的股骨颈骨折患者,按照数字表法随机分为两组,对照组31例,采用人工股骨头置换术;观察组31例,采用全髋关节置换术;观察比较两组手术时间、术中出血量、引流量、住院时间,髋关节功能,视觉模拟评分(VAS评分)和生活质量评分变化,早期并发症.结果 对照组手术时间、术中出血量、引流量和住院时间分别为(87.4±21.3)min、(209.6±34.5)mL、(174.2±29.4) mL和(17.8±5.6)d,观察组分别为(104.2±33.7)min、(229.1±35.1) mL、(182.2±30.5)mL和(18.2±6.2)d.观察组手术时间明显长于对照组(t =4.927,P＜0.05);两组术中出血量、引流量、住院时间差异均无统计学意义(t=0.386、0.413、0.775,均P＞0.05).观察组髋关节功能恢复优良占96.8％ (30/31),明显高于对照组的83.9％ (26/31)(x2=6.92,P＜0.05).对照组在VAS评分变化和生活质量评分变化分别为(23.4±9.2)分和(36.1±11.2)分,观察组分别为(35.1±10.6)分和(42.8±12.6)分,观察组VAS评分变化和生活质量评分变化均高于对照组(t=6.032、3.924,均P＜0.05).观察组发生早期并发症占9.8％(3/31),低于对照组的25.8％(8/31)(x2=13.64,P＜0.01).结论 对于保守治疗或钢板内固定失败的股骨颈骨折患者,采用全髋关节置换虽然手术复杂,但可以明显提高髋关节功能、减少疼痛、提高生活质量和减少早期并发症.
目的 比較全髖關節置換與人工股骨頭置換治療老年人股骨頸骨摺的療效.方法 62例採用保守治療或鋼闆內固定失敗的股骨頸骨摺患者,按照數字錶法隨機分為兩組,對照組31例,採用人工股骨頭置換術;觀察組31例,採用全髖關節置換術;觀察比較兩組手術時間、術中齣血量、引流量、住院時間,髖關節功能,視覺模擬評分(VAS評分)和生活質量評分變化,早期併髮癥.結果 對照組手術時間、術中齣血量、引流量和住院時間分彆為(87.4±21.3)min、(209.6±34.5)mL、(174.2±29.4) mL和(17.8±5.6)d,觀察組分彆為(104.2±33.7)min、(229.1±35.1) mL、(182.2±30.5)mL和(18.2±6.2)d.觀察組手術時間明顯長于對照組(t =4.927,P＜0.05);兩組術中齣血量、引流量、住院時間差異均無統計學意義(t=0.386、0.413、0.775,均P＞0.05).觀察組髖關節功能恢複優良佔96.8％ (30/31),明顯高于對照組的83.9％ (26/31)(x2=6.92,P＜0.05).對照組在VAS評分變化和生活質量評分變化分彆為(23.4±9.2)分和(36.1±11.2)分,觀察組分彆為(35.1±10.6)分和(42.8±12.6)分,觀察組VAS評分變化和生活質量評分變化均高于對照組(t=6.032、3.924,均P＜0.05).觀察組髮生早期併髮癥佔9.8％(3/31),低于對照組的25.8％(8/31)(x2=13.64,P＜0.01).結論 對于保守治療或鋼闆內固定失敗的股骨頸骨摺患者,採用全髖關節置換雖然手術複雜,但可以明顯提高髖關節功能、減少疼痛、提高生活質量和減少早期併髮癥.
목적 비교전관관절치환여인공고골두치환치료노년인고골경골절적료효.방법 62례채용보수치료혹강판내고정실패적고골경골절환자,안조수자표법수궤분위량조,대조조31례,채용인공고골두치환술;관찰조31례,채용전관관절치환술;관찰비교량조수술시간、술중출혈량、인류량、주원시간,관관절공능,시각모의평분(VAS평분)화생활질량평분변화,조기병발증.결과 대조조수술시간、술중출혈량、인류량화주원시간분별위(87.4±21.3)min、(209.6±34.5)mL、(174.2±29.4) mL화(17.8±5.6)d,관찰조분별위(104.2±33.7)min、(229.1±35.1) mL、(182.2±30.5)mL화(18.2±6.2)d.관찰조수술시간명현장우대조조(t =4.927,P＜0.05);량조술중출혈량、인류량、주원시간차이균무통계학의의(t=0.386、0.413、0.775,균P＞0.05).관찰조관관절공능회복우량점96.8％ (30/31),명현고우대조조적83.9％ (26/31)(x2=6.92,P＜0.05).대조조재VAS평분변화화생활질량평분변화분별위(23.4±9.2)분화(36.1±11.2)분,관찰조분별위(35.1±10.6)분화(42.8±12.6)분,관찰조VAS평분변화화생활질량평분변화균고우대조조(t=6.032、3.924,균P＜0.05).관찰조발생조기병발증점9.8％(3/31),저우대조조적25.8％(8/31)(x2=13.64,P＜0.01).결론 대우보수치료혹강판내고정실패적고골경골절환자,채용전관관절치환수연수술복잡,단가이명현제고관관절공능、감소동통、제고생활질량화감소조기병발증.
Objective To study effect of total hip replacement and artificial head of femur replacement in patients with failed femoral neck fracture.Methods 62 cases with failure of the conservative treatment or fixed steel femoral neck fracture were enrolled as research subjects.They were randomly divided into the two groups,the control group (n =31) and the observation group (n =31).They were operated through hemiarthroplasty in the control group,while they were operated through total hip replacement in the observation group.The operative time,blood loss,drainage,hospital stay,hip function,VAS score and quality of life changes,early complications were observed.Results The operative time,blood loss,drainage,length of hospital stay were (87.4 ± 21.3) min,(209.6 ± 34.5) mL,(174.2 ±29.4)mL and (17.8 ±5.6)d in the control group and (104.2 ±33.7)min,(229.1 ±35.1)mL,(182.2 ± 30.5) mL and (18.2 ± 6.2)d in the observation group.The operative time in the observation group was significantly longer than that of the control group (t =4.927,P ＜ 0.05).The blood loss,drainage,length of hospital stay were no significant difference between the two groups (t =0.386,0.413,0.775,all P ＞ 0.05).The excellent rate of hip function was 83.9％ (26/31) in the control group and 96.8％ (30/31) in the observation group,the observation group was significantly higher (x2 =6.92,P ＜ 0.05).Score changes of VAS and quality of life were (23.4 ± 9.2) and (36.1 ± 11.2) in the control group and (35.1 ± 10.6) and (42.8 ± 12.6) in the observation group.Score changes of VAS and quality of life in the observation group were higher (t =6.032,3.924,all P ＜ 0.05).The early complications occurred in the control group was 25.8％ (8/31),which in the observation group was 9.8％ (3/31),the early complications in the observation group was significantly lower than that in the control group (x2 =13.64,P ＜0.01).Conclusion For patients in the conservative treatment or femoral neck fracture fixation failure or steel,the use of total hip replacement surgery was complicated,but it can significantly improve hip function,reduce pain,improve quality of life and reduce early complications.
