全髋关节和双极人工股骨头置换术治疗老年股骨颈骨折的对比观察.docVIP

全髋关节和双极人工股骨头置换术治疗老年股骨颈骨折的对比观察 　　[摘要] 目的 对比全髋关节置换术（THA）和双极人工股骨头置换术（BHA）治疗老年股骨颈骨折的疗效及安全性。方法 采用双盲法将我院收治的178例老年股骨颈骨折患者分为两组，分别行全髋关节置换术和双极人工股骨头置换术，比较两组术中情况、术后效果及并发症等。 结果 BHA组手术时间、术中出血量、住院时间及住院总费用均显著低于THA组（P0.05）；术后1年THA组Harris评分显著高于BHA组 （P0.05），Harris评分优良率显著高于BHA组 （P0.05）；THA术后1年生活质量总评分显著低于BHA组 （P0.05）；THA总并发症率显著低于BHA组 （P0.05）。结论 全髋关节置换术和双极人工股骨头置换术治疗老年股骨颈骨折各具缺点。 　　[关键词] 全髋关节置换术；双极人工股骨头置换术；股骨颈骨折；老年 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2014）11-0134-04 　　[Abstract] Objective To compare the efficacy and safety of the total hip joint（THA） and bipolar artificial femoral head replacement（BHA） on the treatment of the femoral neck fractures in the elderly. Methods A total of 178 cases of femoral neck fracture in our hospital were divided into two groups and performed with total hip arthroplasty and bipolar artificial femoral head， respectively. The situation of intra-operative， postoperative effect and complications of two groups were compared. Results The bleeding amount， operation time， amount， duration of hospitalization and total medical costs in the BHA group were significantly lower than THA group（P0.05）. The harris score after replacement 1 years in the THA group were higher than that of the BHA group （P0.05）. The excellent and good rate in the group BHA were significantly higher than that of the BHA group（P0.05）， while the life quality score replacement after 1 years in the THA group were significantly lower than that of the BHA group（P0.05）. The total complication rate in the THA group was lower than that in BHA group（P0.05）. Conclusion The total hip arthroplasty and bipolar artificial femoral head replacement on the treatment of femoral neck fractures in the elderly has different advantages. 　　[Key words] Total hip anhmlasty； Bipolar artificial femoral head replacement；Femoral neck fractures； Elderly 　　股骨颈骨折是一种常见的骨科创伤，占全身骨折的3.6%，其骨折部位特殊，股骨头坏死率、不愈合率较高，并发症较多，病程长，且有一定的死亡率，在老年人中较为多发[1]。人工关节置换术是目前股骨颈骨折最常用的方法，包括全髋关节置换术（total hip anhmlasty，THA）和双极人工股骨头置换术两种，关于两