髋关节置换手术与动力髋螺钉内固定治疗移位型股骨颈骨折的疗效比较

发布时间：2018-03-03 15:07

本文选题：移位型股骨颈骨骨折　切入点：髋关节置换　出处：《中国现代医学杂志》2017年23期 　论文类型：期刊论文

【摘要】：目的比较髋关节置换手术与动力髋螺钉内固定手术治疗移位型股骨颈骨折患者的临床疗效。方法回顾性分析2014年1-2014年12月该院收治的100例移位型股骨颈骨折患者的临床资料,采用全髋关节置换手术治疗的63例患者设为观察组,采用动力髋螺钉内固定手术治疗的37例患者设为对照组。对比两组患者围手术期情况、术后1年和2年髋关节功能改良Aubigné-Postel评分、术后1和2年并发症发生情况、各项治疗费用。结果观察组的切口长度、术中出血量、输血量、手术时间和住院时间与对照组比较,差异有统计学意义(P0.05)。观察组与对照组术前、术后1年和2年的髋关节功能改良Aubigné-Postel评分比较,采用重复测量设计的方差分析:(1)两组的疼痛,活动范围,行走能力及总分比较,差异有统计学意义(P0.05);(2)不同时间的疼痛、活动范围、行走能力及总分比较,差异无统计学意义(P0.05);(3)两组的疼痛、活动范围、行走能力及总分比较,差异有统计学意义(P0.05)。术后1年观察组和对照组患者的并发症总发生率分别为9.6%和18.9%,术后2年对照组和观察组患者的并发症发生率分别为25.6%和29.7%,差异无统计学意义(P0.05)。观察组的初次手术费用高于对照组,再次手术费用和求医问药费用低于对照组,总费用稍高于对照组。结论采用髋关节置换手术治疗移位型股骨颈骨折较动力髋螺钉内固定治疗近期并发症发生率较低,远期临床疗效较佳,髋关节功能较好,但其治疗总费用稍高,患者可以根据自身情况选择。
[Abstract]:Objective to compare the clinical effects of hip arthroplasty and dynamic hip screw fixation in the treatment of displaced femoral neck fractures. Methods the clinical data of 100 patients with displaced femoral neck fractures treated in our hospital from 2014 to December were retrospectively analyzed. Sixty-three patients treated with total hip replacement were set up as observation group and 37 patients treated with dynamic hip screw fixation as control group. Aubign 茅 -Postel score of hip joint function was improved 1 and 2 years after operation, complications occurred 1 and 2 years after operation, treatment cost. Results the length of incision, intraoperative blood loss, blood transfusion, operation time and hospital stay in the observation group were compared with those in the control group. The difference was statistically significant (P 0.05). The score of modified Aubign 茅 -Postel score of hip joint function before operation, 1 year and 2 years after operation in the observation group and the control group was compared. The pain, range of movement, walking ability and total score of the two groups were compared by the ANOVA of repeated measurement design. The difference was statistically significant (P 0.05) the pain, range of movement, walking ability and total score of the two groups were compared, but there was no significant difference between the two groups in pain, activity range, walking ability and total score, and there was no significant difference between the two groups in pain, activity range, walking ability and total score. The total incidence of complications in the observation group and the control group was 9.6% and 18.9, respectively, while that in the control group and the observation group was 25.6% and 29.70.There was no significant difference in the incidence of complications between the observation group and the control group two years after operation. The cost of initial operation in the observation group was higher than that in the control group. The cost of reoperation and seeking medical advice was lower than that of the control group, and the total cost was slightly higher than that of the control group. Conclusion the incidence of short-term complications in the treatment of displaced femoral neck fractures with hip arthroplasty is lower than that with dynamic hip screw fixation. The long-term clinical effect is better, the hip function is better, but the total cost of treatment is slightly higher, patients can choose according to their own situation.
【作者单位】：四川省泸州市人民医院骨科;四川省泸州市人民医院新生儿科;
【分类号】：R687.3

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