急诊、择期行全髋关节置换术治疗股骨颈骨折的疗效观察(1)
[摘要] 目的 研究急诊和择期行全髋关节置换术治疗股骨颈骨折的临床疗效。 方法 选择2013年3月～2015年3月来我院就诊的60例股骨颈骨折患者作为研究对象，随机分为两组，每组30例。对照组择期行全髋关节置换术，观察组在急诊期即行全髋关节置换术，随访6个月观察两组术后一般情况和髋关节功能恢复情况。 结果 术后1个月观察组髋关节活动功能优良率为60.00%，显著高于对照组的33.33%，差异具有统计学意义(P<0.05)，术后6个月两组优良率比较差异无统计学意义(P>0.05)。观察组手术时间、术中出血量及术后引流量显著低于对照组，差异具有统计学意义(P<0.05)，两组术后并发症发生率比较，差异无统计学意义(P>0.05)。 结论 股骨颈患者在急诊期即行全髋关节置换术近期内可显著改善患者髋关节活动功能及相关症状，效果优于择期手术，但两种手术时机的选择对远期髋关节恢复情况影响不大，临床应根据患者病情，以能迅速缓解疼痛症状，改善髋关节活动功能为准则选择手术时机。
[关键词] 股骨颈骨折；全髋关节置换术；急诊期手术；择期手术
[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701(2016)19-0073-03
[Abstract] Objective To explore the clinical efficacy of emergency and selective total hip arthroplasty(THA) in treatment of femoral neck fracture. Methods 60 patients with femoral neck fracture treated in our hospital from March 2013 to March 2015 were selected and randomly divided into two groups， each with 30 cases. Patients in the control group were given selected THA， while those in the observation group were given emergency THA. The patients were followed up for 6 months to observe the general conditions after operation and the recovery of hip joint. Results The excellent and good rate of activity function of hip joint was 60% in the observation group at 1 month after operation， which was significantly higher than the 33.33% in the control group(P<0.05). There was no significant difference between two groups at 6 months after operation(P>0.05). The duration of operation， blood loss in operation， and postoperative drainage volume in the observation group were significantly shorter/lower than those on the control group(P<0.05). There was no significant difference in incidence of complications between two groups(P>0.05). Conclusion The short-term effect of emergency THA is better than that of selective THA in patients with femoral neck fracture by improving the activity function and symptoms of the hip joint. But the long-term effects show little difference between two methods of operation. To choose the proper operation time， surgeons should consider the condition of patients， to rapidly relieve pain and improve the activity function of hip joint.
[Key words] Femoral neck fracture； Total hip arthroplasty； Emergency surgery； Selective surgery
股骨颈骨折主要是因患者骨质疏松、髋周肌群退变不能抵消髋部有害应力所致，好发于中老年人。骨折发生后可并发关节脱位、骨盆骨折及休克，严重时可引起股骨头缺血性坏死和创伤性关节炎，严重影响患者工作和生活。全髋关节置换术是目前治疗股骨颈骨折主要的外科手术方法之一，近年来，学界对何时行该置换术能取得最佳疗效尚存争议[1-2]，为此，我院开展了急诊和择期行全髋关节置换术的对比研究，现报道如下。
1 资料与方法
1.1 一般资料
选择2013年3月～2015年3月来我院就诊的60例股骨颈骨折患者作为研究对象，随机分为两组，每组30例。对照组男16例，女14例；年龄52～78岁，平均(63.7±9.4)岁；骨折原因：跌倒12例，高处坠落11例，交通事故7例。观察组男17例，女13例；年龄54～80岁，平均(64.1±8.8)岁；骨折原因：跌倒13例，高处坠落12例，交通事故5例。所有患者均为闭合性损伤。两组患者在性别、年龄、骨折原因等基本病历资料方面比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(王文广)
[关键词] 股骨颈骨折；全髋关节置换术；急诊期手术；择期手术
[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701(2016)19-0073-03
[Abstract] Objective To explore the clinical efficacy of emergency and selective total hip arthroplasty(THA) in treatment of femoral neck fracture. Methods 60 patients with femoral neck fracture treated in our hospital from March 2013 to March 2015 were selected and randomly divided into two groups， each with 30 cases. Patients in the control group were given selected THA， while those in the observation group were given emergency THA. The patients were followed up for 6 months to observe the general conditions after operation and the recovery of hip joint. Results The excellent and good rate of activity function of hip joint was 60% in the observation group at 1 month after operation， which was significantly higher than the 33.33% in the control group(P<0.05). There was no significant difference between two groups at 6 months after operation(P>0.05). The duration of operation， blood loss in operation， and postoperative drainage volume in the observation group were significantly shorter/lower than those on the control group(P<0.05). There was no significant difference in incidence of complications between two groups(P>0.05). Conclusion The short-term effect of emergency THA is better than that of selective THA in patients with femoral neck fracture by improving the activity function and symptoms of the hip joint. But the long-term effects show little difference between two methods of operation. To choose the proper operation time， surgeons should consider the condition of patients， to rapidly relieve pain and improve the activity function of hip joint.
[Key words] Femoral neck fracture； Total hip arthroplasty； Emergency surgery； Selective surgery
股骨颈骨折主要是因患者骨质疏松、髋周肌群退变不能抵消髋部有害应力所致，好发于中老年人。骨折发生后可并发关节脱位、骨盆骨折及休克，严重时可引起股骨头缺血性坏死和创伤性关节炎，严重影响患者工作和生活。全髋关节置换术是目前治疗股骨颈骨折主要的外科手术方法之一，近年来，学界对何时行该置换术能取得最佳疗效尚存争议[1-2]，为此，我院开展了急诊和择期行全髋关节置换术的对比研究，现报道如下。
1 资料与方法
1.1 一般资料
选择2013年3月～2015年3月来我院就诊的60例股骨颈骨折患者作为研究对象，随机分为两组，每组30例。对照组男16例，女14例；年龄52～78岁，平均(63.7±9.4)岁；骨折原因：跌倒12例，高处坠落11例，交通事故7例。观察组男17例，女13例；年龄54～80岁，平均(64.1±8.8)岁；骨折原因：跌倒13例，高处坠落12例，交通事故5例。所有患者均为闭合性损伤。两组患者在性别、年龄、骨折原因等基本病历资料方面比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(王文广)