【作者】 罗宇文；

【导师】 蒋卫平；

【作者基本信息】 广西医科大学 ， 骨外科， 2010， 硕士

【摘要】 目的:通过人工股骨头置换术组与人工全髋置换术组治疗老年股骨颈骨折的临床疗效对比,对人工股骨头置换术与人工全髋置换术的治疗效果进行分析。方法:通过回顾研究广西医科大学第三附属医院骨科从2003年3月至2009年3月期间收治的57例老年股骨颈骨折患者,将患者分为两组。A组为人工股骨头置换组,B组为人工全髋置换术组。通过两组患者的手术时间、术中失血量、术后引流量、住院时间、术后负重时间、术后早期并发症、术后远期并发症及术后髋关节功能恢复程度等方面来比较它们的差异。结果:两组病人经过6个月～6年(平均26.5月)随访,人工股骨头置换组和全髋关节置换组在住院时间、术后负重时间,术后早期并发症方面比较,差异无统计学意义(p>0.05);而在手术时间、术中出血量、术后引流量、术后远期并发症及髋关节功能方面比较,差异有统计学意义(p <0.05)。结论:老年股骨颈骨折行人工全髋关节置换后关节功能恢复较好,远期并发症较低,是人工髋关节置换治疗的首选方法。即使是高龄患者,如自身身体状况许可,预期寿命长或活动量较大者,亦优先选择人工全髋置换术。人工股骨头置换术适用于身体情况较差、预期寿命短或活动量小的患者。更多还原

【Abstract】 Objective:By comparing the clinical therapeutics of artificial femoral head replacement group with total hip arthroplasty group of therapy of the elderly femoral neck fracture, to analyze the treatment effect of the two surgical procedures.Method:Based on the observation of 57 cases of patients with elderly femoral neck fracture in the Third Affiliated Hospital of Guangxi Medical University from March 2003 to March 2009, we separated the patients into two groups, group A for artificial femoral head replacement and B for total hip arthroplasty. We compared the two groups from operative time, intra-operative blood lose, postoperative drainage, hospitalization period, time of postoperative weight-bearing, early postoperative complications, long-term postoperative complications, and postoperative recovery of hip function.Results: Two groups of patients are interviewed randomly from 6 months to 6 years, 26.5 months on average. There was no significant difference between A group with B group in hospitalization period, time of postoperative weight-bearing, and early postoperative complications (p > 0.05). However, operative time, intra-operative blood loses, postoperative drainage, long-term postoperative complications, and postoperative recovery of hip function between the two group showed significant difference (p < 0.05).Conclusion: Total hip arthroplasty has higher recovery rate of hip function, less long-term postoperative complications, and is the preferred method of artificial hip replacement, even for elderly patients if in better health conditions, have longer life expectancy, or with larger exercise-load. Accordingly, for patients in worse health condition, with shorter life expectancy, or with smaller exercise-load, artificial femoral head replacement is a more suitable method.更多还原