人工股骨头置换术与全髋关节置换术治疗骨质疏松性股骨颈骨折的临床效果.doc

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1、人工股骨头置换术与全競关节置换术治疗骨质疏松性股骨颈骨折的临床效果［摘要］目的观察人工股骨头置换术与全髓关节置换术治疗骨质疏松性股骨颈骨折的临床效果。方法回顾性分析2012年8月〜2015年2月北京中医药大学东直门医院收治的98例骨质疏松性股骨颈骨折患者的临床资料，按照手术方式的不同将其分为人工股骨头置换术组(46例)、全骯关节置换术组(52例)。比较两组患者手术时间、术中出血量及住院吋间，记录两组术后12个月Harris髓关节功能评分并评价其疗效，观察两组术后12个月并发症发生情况。结果全骯关节置换术组手术时间［(126.44±35.91)h］明显长于人工

2、股骨头置换术组［(94.58±23.72)h］,术中出血量［(452.64±66.78)mL］明显多于人工股骨头置换术组［(310.37±52.75)mL］,差异均有统计学意义(均P0.05)。全髓关节置换术组术后12个月髓关节功能优良率为90.38%,人工股骨头置换术组为80.43%,两组豔关节功能优良率比较差异有统计学意义(P0.05)o结论人工股骨头置换术与全襯关节置换术治疗骨质疏松性股骨颈骨折各有利弊，因此需严格术前评估，针对不同患者采用不同的术式，对于伤前活动能力较弱、全身情况较差的高龄患者宜釆用人工股骨头置换术，对于伤前活动能力较强、身体健康状况

3、较好的患者宜采用全競关节置换术。［关键词］人工股骨头置换术；全髓关节置换术；骨质疏松；股骨颈骨折；临床效果[中图分类号]R683.42[文献标识码]A[文章编号]1673-7210(2016)05(c)-0100-04[Abstract]ObjectiveToobservetheclinicaleffectofaprostheticreplacementandtotalhipreplacementinthetreatmentofosteoporoticfemoralneckfracture・MethodsTheclinicaldataof98caseswit

4、hosteoporoticfemoralneckfractureadmittedtoDongzhimenHospital,BeijingUniversityofChineseMedicinefromAugust2012toFebruary2015wasanalyzedretrospectively.Thepatientsweredividedintoprostheticreplacementgroup(46cases)andtotalhipreplacementgroup(52cases)accordingtodifferentsurgicalmethods

5、・Theoperationtime,intraoperatvebloodlossandthehospitaistayofthetwogroupswerecompared；theHarrishipscoresofthetwogroupsafteroperationfor12monthswererecordedandtheeffectswereevaluated；thecomplicati()nsafteroperationfor12monthsofthetwogroupswereobserved・ResultsTheoperationtime[(126.44+

6、35.91)h]oftotalhipreplacementgroupwaslongerthanthatofprostheticreplacementgroup[(94.58+23・72)h],theintraoperatvebloodloss[(452・64±66.78)mL]wasmorethanthatofprostheticreplacementgroup[(310.37+52.75)mL],andthehospitalstaybetweenthetwogroupshadnostatisticallysignificantdifferenee(P>0.

7、05)・Theexcellentandgoodrateofhipjointfunctionafteroperationfor12monthsintotalhipreplacementgroupwas90.38%,whichofprostheticreplacementgroupwas80.43%,thedifferencebetweenthetwogroupswasstatisticallysignificant(P0.05)・ConclusionProstheticreplacementandtotalhipreplacementinthetreatmen

8、tofosteoporoticfemoralneck