摘要
目的回顾2015年1月—2018年3月180例分别行生物型与骨水泥型人工半髋关节假体置换的高龄股骨颈骨患者,行疗效比较分析,以选择更加有效可行的治疗方案。方法2015年1月—2018年3月选取180例行人工半髋关节置换术的高龄股骨颈骨折患者(排除术后1年内自然死亡患者),根据术中应用假体类型分为A组(骨水泥型假体,90例)和B组(远端固定型生物型假体,90例)。对两组患者术后第3、6、12个月的Harris评分,两组患者手术时间、术中出血量、术后出血引流量、置换后活动时间、并发症(深静脉血栓、肺部感染、切口感染、臀部压疮、水电解质失衡、尿路感染、死亡率等)进行比较分析。结果两组患者术后6个月、12个月Harris评分、置换后开始活动时间、术后假体翻修率及术后并发症发生率均差异无统计学意义(P>0.05),术后3个月Harris评分、术中患者的出血量和手术时间、术后出血量、术中血压变化,二者差异有统计学意义(P<0.05)。结论在高龄股骨颈骨折患者行人工半髋关节置换术治疗的过程中,两种假体远期疗效基本相当,但远端固定型生物型假体具有缩短手术时间、避免骨水泥毒反应等优点,适合在高龄患者中应用。
Objective A total of 180 cases of elderly patients with femoral neck fracture who underwent biologic or bone-cement hemiarthroplasty were reviewed from January 2015 to March 2018,and the therapeutic effect was compared and analyzed to select a more effective and feasible treatment scheme.Methods From January 2015 to March 2018,a retrospective study including 180 randomly picked elder patients after femoral neck fracture was conducted(patients naturally died within 1 year after surgery were dismissed).All the patients were divided into two groups according to the prosthesis used during operation.Group A included 90 patients using cemented prosthesis while group B included 90 patients using uncemented prosthesis.Then compared these two groups of Harris grades(3,6,12 months post-operation),operation time,bleeding amount,drainage volume,activity time after replacement,postoperative complications(including deep venous thrombosis,lung infection,incision infection,pressure sores,electrolyte imbalance,urinary infection,death rate,etc.).Results There was no significant difference in Harris scores,functional activity time after replacement,postoperative prosthesis revision rate,and incidence of postoperative complications between the two groups of patients at 6 months and 12 months after surgery(P>0.05).There were statistically significant differences in Harris score,intraoperative blood loss and operation time,postoperative blood loss and intraoperative blood pressure at 3 months after operation(P<0.05).Conclusion The efficacy of treatment showed no significant difference between cemented and uncemented prosthesis for elder patients after femoral neck fracture.However,uncemented prosthesis revealed great reduction of surgery duration as well as less toxic effect of cemented stem.Uncemented prosthesis was effective for femoral neck fracture patients especially elder ones.
作者
王嘉鹏
白晋平
刘平
林霞
WANG Jiapeng;BAI Jinping;LIU Ping;LIN Xia(Department of Orthopedics,Jilin Province FAW General Hospital,Changchun Jilin 130000,China;Department of Radiotherapy,Second Hospital of Jilin University,Changchun Jilin 130000,China)
出处
《中国卫生标准管理》
2021年第21期57-61,共5页
China Health Standard Management
关键词
股骨颈骨折
人工关节
半髋关节
高龄患者
创伤
骨质疏松症
femoral neck fracture
artificial joint
hemi hip joint
elderly patients
trauma
osteoporosis
