摘要
目的比较直接前入路(DAA)和后外侧入路(PLA)人工股骨头置换术治疗高龄股骨颈骨折患者的早期临床疗效。方法选择2016年8月至2020年8月该科室收治的符合本研究纳入标准的68例高龄单侧股骨颈骨折患者,均采用双极人工股骨头置换术治疗。根据手术入路将其分为DAA组(n=36)和PLA组(n=32);记录并比较2组手术时间、切口长度、术中出血量、术后疼痛视觉模拟评分法(VAS)、下地活动时间、住院时间、髋关节功能Harris评分及术后相关并发症发生情况。结果DAA组手术时间、术中出血量、早期VAS评分、住院时间及下地活动时间均优于PLA组(P<0.05);DAA组在术后1周、1个月、3个月的髋关节Harris评分较PLA组更高(P<0.05),术后6个月时2组Harris评分比较,差异无统计学意义(P>0.05);与PLA组比较,DAA组总体并发症发生率更低,差异有统计学意义(P<0.05)。结论DAA双极人工股骨头置换术治疗高龄股骨颈骨折具有手术时间短、术中出血少、术后下地时间早、疼痛缓解快、住院时间短、总体并发症发生率低等优点,术后可尽快改善患者髋关节功能,提升高龄患者生存质量。
Objective To compare the early clinical efficacy of direct anterior approach(DAA)and posterolateral approach(PLA)artificial femoral head replacement in elderly patients with femoral neck fractures.Methods A total of 68 elderly patients with unilateral femoral neck fracture meeting the inclusion criteria of this study admitted and treated in the First Orthopedic Department of this hospital from August 2016 to August 2020 were selected and treated with artificial bipolar femoral head replacement.According to the surgical approach,they were divided into the DAA group(36 cases)and the PLA group(n=32 cases);the operation time,incision length,intraoperative blood loss amount,postoperative pain visual analogue scale(VAS)score,time of walking,length of hospital stay,Harris score of hip joint function and postoperative related complications were recorded and compared between the two groups.Results The operation time,intraoperative blood loss amount,early VAS score,length of hospital stay and time of walking in the DAA group were better than those in the PLA group(P<0.05);the Harris score of hip joint in the DAA group was higher than those in the PLA group at the time of 1 week,1 month and 3 months after operation(P<0.05),and there was no statistically significant difference between the two groups at the time of 6 months after operation(P>0.05);compared with the PLA group,the overall complications occurrence rate in the DAA group was lower,and the difference was statistically significant(P<0.05).Conclusion DAA bipolar artificial femoral head replacement in the treatment of femoral neck fractures of elderly has the advantages of operation time,of intraoperative blood loss,early of postoperative landing time,quick of pain relief,short of hospital stay and low of overall complication rate.The postoperative hip joint function of the patients could be improved as soon as possible and their quality of life could be increased.
作者
高速
陆慧
GAO Su;LU Hui(First Department of Orthopedics,Chongqing Jiangjin Hospital University,Chongqing 402260,China)
出处
《重庆医学》
CAS
2022年第21期3699-3703,共5页
Chongqing medicine
关键词
直接前入路
后外侧入路
高龄老人
股骨颈骨折
人工股骨头置换术
direct anterior approach
posterolateral approach
elderly people
femoral neck fracture
artificial femoral head replacement
