摘要
目的:比较老年股骨颈骨折患者接受直接前入路(DAA)与后外侧入路(PLA)髋关节置换术治疗的疗效。方法:将2019年8月至2021年6月深圳市第二人民医院接诊且行PLA髋关节置换术治疗的79例老年股骨颈骨折患者作为对照组,将同期深圳市第二人民医院接诊且行DAA髋关节置换术治疗的79例老年股骨颈骨折患者作为观察组,比较两组患者的髋关节Harris评分、疼痛评分、住院时间、术后3个月假体脱位率及死亡率、住院期间并发症、肌肉损伤程度指标。结果:(1)观察组术后2周、6周、6个月时的Harris评分高于对照组,差异均具有统计学意义(P<0.05);(2)观察组术后24 h、48 h、72 h时的视觉模拟评分法(VAS)评分低于对照组,差异均具有统计学意义(P<0.05);(3)观察组住院时间、术后3个月假体脱位率均少于对照组,差异均具有统计学意义(P<0.05);(4)在院期间,观察组患者的并发症发生率为2.53%,低于对照组的11.39%,差异具有统计学意义(P<0.05);(5)观察组术后1~2 d的肌红蛋白、肌酸激酶、C反应蛋白、白细胞介素-6水平均低于对照组,差异均具有统计学意义(P<0.05)。结论:对老年股骨颈骨折患者行DAA髋关节置换术,可以减少并发症,减轻疼痛刺激与肌肉损伤程度,尽快促进髋关节功能恢复,缩短病程。
Objective To analyze the effect of direct anterior approach(DAA)and posterolateral approach(PLA)Hip arthroplasty in elderly patients with femoral neck fracture.Methods 79 elderly patients with femoral neck fracture treated with PLA Hip arthroplasty in the Second People's Hospital of Shenzhen from August 2019 to June 2021 were enrolled as the control group,and 79 elderly patients with femoral neck fracture treated with DAA Hip arthroplasty in Shenzhen Second People's Hospital during the same period were enrolled as the observation group.Harris hip score,pain score,length of hospital stay,3 months after surgery prosthesis dislocation rate and mortality,complications during hospital stay,and muscle injury degree were compared between the two groups.Results(1)The Harris score of the observation group at 2 weeks,6 weeks and 6 months after surgery was higher than that of the control group,with statistical significance(P<0.05);(2)The visual analogue scale(VAS)pain score of the observation group at 24 h,48 h and 72 h after surgery was lower than that of the control group,with statistical significance(P<0.05).(3)The length of hospital stay and the rate of prosthesis dislocation 3 months after operation in the observation group were less than those in the control group,with statistical significance(P<0.05).(4)During hospitalization,the incidence of complications in the observation group was 2.53%,lower than that in the control group(11.39%),and the difference was statistically significant(P<0.05).(5)The levels of myoglobin,creatine kinase,C-reactive protein and interleukin-6 in the observation group were lower than those in the control group 1-2 days after operation,with statistical significance(P<0.05).Conclusion DAA Hip arthroplasty for elderly patients with femoral neck fracture can reduce complications,reduce pain stimulation and muscle injury,promote hip function recovery as soon as possible,and shorten the course of disease.
作者
谢伟
尚宏喜
孙炜
XIE Wei;SHANG Hong-xi;SUN Wei(The Second People's Hospital of Shenzhen,The First Affiliated Hospital of Shenzhen University,Guangdong Shenzhen 518035)
出处
《深圳中西医结合杂志》
2022年第1期95-98,共4页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
基金
2020年广东省高水平临床重点专科资助课题(SZGSP007-20203357022)。
关键词
股骨颈骨折
直接前入路髋关节置换术
后外侧入路髋关节置换术
老年人
Femoral neck fracture
Direct anterior approach for Hip arthroplasty
Posterolateral approach for Hip arthroplasty
Elderly
