人工髋关节置换治疗高龄股骨颈骨折

查正; 杨朝晖; 邱新建; 黄凯

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人工髋关节置换治疗高龄股骨颈骨折

查正 , 杨朝晖 , 邱新建 , 黄凯

文章导航 > 蚌埠医学院学报 > 2007, 32 > 5: (566-568)

引用本文:

Citation:

人工髋关节置换治疗高龄股骨颈骨折

安徽省安庆市第一人民医院骨科, 246000

作者简介: 查正(1965-),男,副主任医师.

中图分类号: R683.42

Hip replacement in aged patients with fractures of femoral neck

Department of Orthopedics, Anqing First People's Hospital, Anqing 246000, China
CLC number: R683.42

摘要: 目的: 探讨人工髋关节置换治疗高龄股骨颈骨折的可行性、安全性,提出围手术期处理方法和关节置换方式。方法: 回顾分析2000年3月~2006年9月人工关节置换治疗70岁以上的股骨颈骨折26例的疗效及并发症情况,比较两组人工股骨头置换组20例和全髋置换组6例的平均住院时间、手术时间、术中和术后出血量、输血量、Harris评分、下地时间等的差异。结果: 两组术中、术后均无病死,Harris评分平均改善38.2分,优良率为88.46%,并发症发生5例,发生率19.23%;人工股骨头置换组在手术时间、术中、术后出血量、输血量均明显低于全髋置换组(P<0.01~P<0.001),而Harris评分、下床时间和住院时间两组差异均有统计学意义(P<0.001和P<0.01)。结论: 对高龄股骨颈骨折患者,人工关节置换为有效的治疗方式,能显著改善患者的生存质量,只要经过正确的围手术期处理,该类患者能度过围手术期,取得良好的治疗效果;两种手术方式中人工股骨头置换更适合80岁以上高龄股骨颈骨折患者。
- 股骨颈骨折 /
- 髋关节置换术,全
Abstract: Objective: To explore the feasibility and safety of hip arthroplasty in treatment of femoral neck fracture and propose the perioperative approach and the methods of arthroplasty. Methods: Retrospective analysis of the efficacy and complications of artificial joint replacement in 26 patients aged more than 70 years old with fractures of the femoral neck from March 2000 to September 2006 were performed. The average duration of hospitalization, the surgical time, the intraoperative and postoperative bleeding, the blood transfusion, Harris score, the time to get out of bed were compared between the hemiarthroplasty group of 20 patients and total hip replacement group of 6 patients. Results: No patients in the two groups died intraoperatively and postoperatively. Harris score improved by an average of 38.2 and the excellent rate was 88.46%. The complications occurred in 5 patients with the incidence of 19.23%. The operative time, the intraoperative and postoperative bleeding, blood transfusion, the incidence of complications in hemiarthroplasty group were significantly lower than those in the total hip replacement group (P<0.01-P<0.001). There were no significant differences in Harris and the score, time to get out of bed, the average length of stay between the two groups (P<0.001-P<0.01). Conclusions: Elderly patients with femoral neck fracture, artificial joint replacement for effective treatment, can significantly improve the patient's quality of life. The correct perioperative management can help such patients pass through the perioperative period and achieve good results. For the two surgical approaches, hemiarthroplasty is more suitable for 80 older patients with femoral neck fracture.
- femoral neck fracture /
- hip replacement,total

[1]	杨朝晖 , 邱新建 , 张潇 , 黄凯 . 空心拉力螺钉内固定术与人工关节置换术治疗股骨颈新鲜骨折的疗效分析. 蚌埠医学院学报, 2007, 32(5): 564-566.
[2]	朱晓龙 , 宋修刚 , 李磊 , 鞠昌军 , 邹德宝 , 姜红江 . SuperPATH微创全髋关节置换术治疗老年股骨颈骨折的短期疗效观察. 蚌埠医学院学报, 2019, 44(12): 1656-1659. doi: 10.13898/j.cnki.issn.1000-2200.2019.12.021
[3]	黄明 , 厉文华 , 冯磊 , 高明杰 , 张庆 , 陈伯民 . 卡式双极人工股骨头置换治疗老年人股骨颈骨折. 蚌埠医学院学报, 2005, 30(5): 415-416.
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[6]	凌云志 , 赵永娟 , 赵佑君 , 王刚 . 围术期心理支持疗法对老年股骨颈骨折患者术后认知功能的影响. 蚌埠医学院学报, 2013, 37(5): 531-533.
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人工髋关节置换治疗高龄股骨颈骨折

作者简介: 查正(1965-),男,副主任医师.

安徽省安庆市第一人民医院骨科, 246000

收稿日期: 2007-01-06

关键词:

股骨颈骨折 /
髋关节置换术,全

摘要: 目的: 探讨人工髋关节置换治疗高龄股骨颈骨折的可行性、安全性,提出围手术期处理方法和关节置换方式。方法: 回顾分析2000年3月~2006年9月人工关节置换治疗70岁以上的股骨颈骨折26例的疗效及并发症情况,比较两组人工股骨头置换组20例和全髋置换组6例的平均住院时间、手术时间、术中和术后出血量、输血量、Harris评分、下地时间等的差异。结果: 两组术中、术后均无病死,Harris评分平均改善38.2分,优良率为88.46%,并发症发生5例,发生率19.23%;人工股骨头置换组在手术时间、术中、术后出血量、输血量均明显低于全髋置换组(P<0.01~P<0.001),而Harris评分、下床时间和住院时间两组差异均有统计学意义(P<0.001和P<0.01)。结论: 对高龄股骨颈骨折患者,人工关节置换为有效的治疗方式,能显著改善患者的生存质量,只要经过正确的围手术期处理,该类患者能度过围手术期,取得良好的治疗效果;两种手术方式中人工股骨头置换更适合80岁以上高龄股骨颈骨折患者。

English Abstract

Hip replacement in aged patients with fractures of femoral neck

Department of Orthopedics, Anqing First People's Hospital, Anqing 246000, China

Received Date: 2007-01-06

Abstract: Objective: To explore the feasibility and safety of hip arthroplasty in treatment of femoral neck fracture and propose the perioperative approach and the methods of arthroplasty. Methods: Retrospective analysis of the efficacy and complications of artificial joint replacement in 26 patients aged more than 70 years old with fractures of the femoral neck from March 2000 to September 2006 were performed. The average duration of hospitalization, the surgical time, the intraoperative and postoperative bleeding, the blood transfusion, Harris score, the time to get out of bed were compared between the hemiarthroplasty group of 20 patients and total hip replacement group of 6 patients. Results: No patients in the two groups died intraoperatively and postoperatively. Harris score improved by an average of 38.2 and the excellent rate was 88.46%. The complications occurred in 5 patients with the incidence of 19.23%. The operative time, the intraoperative and postoperative bleeding, blood transfusion, the incidence of complications in hemiarthroplasty group were significantly lower than those in the total hip replacement group (P<0.01-P<0.001). There were no significant differences in Harris and the score, time to get out of bed, the average length of stay between the two groups (P<0.001-P<0.01). Conclusions: Elderly patients with femoral neck fracture, artificial joint replacement for effective treatment, can significantly improve the patient's quality of life. The correct perioperative management can help such patients pass through the perioperative period and achieve good results. For the two surgical approaches, hemiarthroplasty is more suitable for 80 older patients with femoral neck fracture.