中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
35期
5583-5587
,共5页
植入物%人工假体%股骨颈骨折%全髋关节置换%空心加压螺钉%中老年患者%髋关节功能
植入物%人工假體%股骨頸骨摺%全髖關節置換%空心加壓螺釘%中老年患者%髖關節功能
식입물%인공가체%고골경골절%전관관절치환%공심가압라정%중노년환자%관관절공능
Femoral Fractures%Arthroplasty,Replacement,Hip%Internal Fixators
背景：股骨颈骨折的修复方法包括内固定和髋关节置换，患者修复方法的选择受多种因素影响，包括年龄、病情、自身身体情况等。股骨颈骨折修复方法的选择一直存在争议。<br> 目的：对比中老年股骨颈骨折患者行全髋关节置换与空心螺钉置入内固定治疗后的髋关节功能及预后。<br> 方法：选取2012年4月至2014年2月日照市中医医院收治的140例股骨颈骨折患者，年龄小于60岁，随机分为置换组和内固定组，每组70例。置换组采用全髋关节置换治疗，内固定组患者采取空心加压螺钉置入内固定治疗。观察两组患者治疗后1个月的髋关节功能Harris评分、并发症发生情况及关节功能满意度，并进行对比分析。<br> 结果与结论：治疗后1个月，置换组Harris评分的优良率为90%，明显高于内固定组63%，差异有显著性意义(P<0.05)；置换组并发症发生率为6%，明显低于内固定组29%，差异有显著性意义(P<0.05)。置换组患者满意度为93%，明显高于内固定组满意度79%，差异有显著性意义(P <0.05)。提示全髋关节置换对于中老年股骨颈骨折患者来说，关节功能恢复得更快，并发症较少，适合于追求高生存活动质量的患者；而空心加压螺钉置入内固定适用于术前骨质量较好的中年及老年患者。
揹景：股骨頸骨摺的脩複方法包括內固定和髖關節置換，患者脩複方法的選擇受多種因素影響，包括年齡、病情、自身身體情況等。股骨頸骨摺脩複方法的選擇一直存在爭議。<br> 目的：對比中老年股骨頸骨摺患者行全髖關節置換與空心螺釘置入內固定治療後的髖關節功能及預後。<br> 方法：選取2012年4月至2014年2月日照市中醫醫院收治的140例股骨頸骨摺患者，年齡小于60歲，隨機分為置換組和內固定組，每組70例。置換組採用全髖關節置換治療，內固定組患者採取空心加壓螺釘置入內固定治療。觀察兩組患者治療後1箇月的髖關節功能Harris評分、併髮癥髮生情況及關節功能滿意度，併進行對比分析。<br> 結果與結論：治療後1箇月，置換組Harris評分的優良率為90%，明顯高于內固定組63%，差異有顯著性意義(P<0.05)；置換組併髮癥髮生率為6%，明顯低于內固定組29%，差異有顯著性意義(P<0.05)。置換組患者滿意度為93%，明顯高于內固定組滿意度79%，差異有顯著性意義(P <0.05)。提示全髖關節置換對于中老年股骨頸骨摺患者來說，關節功能恢複得更快，併髮癥較少，適閤于追求高生存活動質量的患者；而空心加壓螺釘置入內固定適用于術前骨質量較好的中年及老年患者。
배경：고골경골절적수복방법포괄내고정화관관절치환，환자수복방법적선택수다충인소영향，포괄년령、병정、자신신체정황등。고골경골절수복방법적선택일직존재쟁의。<br> 목적：대비중노년고골경골절환자행전관관절치환여공심라정치입내고정치료후적관관절공능급예후。<br> 방법：선취2012년4월지2014년2월일조시중의의원수치적140례고골경골절환자，년령소우60세，수궤분위치환조화내고정조，매조70례。치환조채용전관관절치환치료，내고정조환자채취공심가압라정치입내고정치료。관찰량조환자치료후1개월적관관절공능Harris평분、병발증발생정황급관절공능만의도，병진행대비분석。<br> 결과여결론：치료후1개월，치환조Harris평분적우량솔위90%，명현고우내고정조63%，차이유현저성의의(P<0.05)；치환조병발증발생솔위6%，명현저우내고정조29%，차이유현저성의의(P<0.05)。치환조환자만의도위93%，명현고우내고정조만의도79%，차이유현저성의의(P <0.05)。제시전관관절치환대우중노년고골경골절환자래설，관절공능회복득경쾌，병발증교소，괄합우추구고생존활동질량적환자；이공심가압라정치입내고정괄용우술전골질량교호적중년급노년환자。
BACKGROUND:The repair method of femoral neck fractures included internal fixation and hip arthroplasty. The selection of repair methods is affected by many factors, such as age, condition of patients, and own physical condition. The selection of repair methods for femoral neck fractures is always controversial. <br> OBJECTIVE:To compare the hip function and prognosis of elderly patients with femoral neck fractures after total hip arthroplasty and hol ow screw fixation. <br> METHODS:140 patients aged less than 60 years, who accepted treatment in Rizhao Hospital of Traditional Chinese Medicine from April 2012 to February 2014, were selected. They were randomly divided into replacement group and fixation group (n=70). Patients in the replacement group received total hip arthroplasty, and patients in the fixation group received hol ow compression screw fixation. Harris score of the hip, complications and satisfactions of the hip were observed, compared and analyzed between the two groups at 1 month post surgery. <br> RESULTS AND CONCLUSION:The excel ent and good rate of Harris score at 1 month post surgery was significantly higher in the replacement group (90%) than in the fixation group (63%) (P<0.05). The incidence of complications was significantly lower in the replacement group (6%) than in the fixation group (29%) (P<0.05). The satisfaction was significantly higher in the replacement group (93%) than in the fixation group (79%) (P<0.05). These results verify that the application of total hip arthroplasty for middle-aged and elder patients with femoral neck fracture has a rapid recovery on joint function, has fewer complications, and is suitable for patients who pursue high-quality survival activities. Cannulated compression screw fixation is suitable for middle-aged and elder patients with good quality of preoperative bone.
