全髋关节置换术与人工股骨头置换术治疗老年新鲜股骨颈骨折的对比研究

王锋 张伟 房玉利

[摘要] 目的 比较全髋关节置换术与人工股骨头置换术治疗老年新鲜股骨颈骨折的手术效果及并发症情况。 方法 选择我院2012年12月～2013年12月接受人工关节置换的老年股骨颈骨折患者60例，全部患者根据治疗方法不同分成A组（全髋关节置换术）和B组（人工股骨头置换术），每组30例，观察并比较两组患者的手术时间、出血量、术后1年Harris评分、术后髋关节功能的优良率及并发症情况。 结果 A组行全髋关节置换术患者的手术时间较长、术中出血量较多，但术后1年的Harris评分显著高于B组（P<0.01或P<0.05）。术后随访1年，A组患者术后髋关节功能的优良率达86.7%，B组患者术后髋关节功能的优良率达73.3%，两组比较差异具有统计学意义（χ2=4.736，P<0.05）。 结论 全髋关节置换术与人工股骨头置换术均为治疗老年新鲜股骨颈骨折有效的治疗方法，与人工股骨头置换术相比，全髋关节置换术手术效果更好，且并发症发生率低。

[关键词] 全髋关节置换术；人工股骨头置换术；老年；股骨颈骨折；并发症

[中图分类号] R687.3 [文献标识码] B [文章编号] 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