| 杨波.不同手术入路的髋关节置换术对老年股骨颈骨折患者的临床疗效对比[J].实用中西医结合临床,2023,23(12):5-9 |
| 不同手术入路的髋关节置换术对老年股骨颈骨折患者的临床疗效对比 |
| Comparison of Clinical Effects of Hip Joint Replacement with Different Surgical Approaches on Elderly Patients with Femoral Neck Fracture |
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| DOI： |
| 中文关键词: 股骨颈骨折 髋关节置换术 前方入路 外侧入路 老年 髋关节功能 疼痛 |
| 英文关键词: Femoral neck fracture Total hip arthroplasty Direct anterior approach Lateral approach Elderly Hip function Pain |
| 基金项目: |
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| 中文摘要: |
| 目的:探讨前方入路与外侧入路髋关节置换术对老年股骨颈骨折患者髋关节功能、疼痛及骨代 谢 功 能 的影响。 方法:将 2020 年 1 月至 2022 年 6 月医院行髋关节置换术的老年股骨颈骨折患者 79 例作为研究对象,根据手术入路不同分为观察组( 40 例,行前方入路髋关节置换术)和对照组( 39 例,行外侧入路髋关节置换术)。 比较两组围术期指标、髋关节功能、骨代谢功能、疼痛程度及并发症发生情况。 结果:两组手术时间比较,差异无统计学意义( P>0.05 );观察组术中出血量、术后引流量、首次下床活动时间均优于对照组( P<0.05 );两组髋关节功能( Harris )评分在术后 1 个月、 3 个月、 6 个月较术前均升高,且观察组 Harris 评分在术后 1 个月、 3 个月时均高于对照组( P<0.05 );术后 1 个 月 ,观 察 组 血 清 I 型 胶 原 氨 基 端 前 肽 ( PINP )、成 纤 维 细 胞 因 子 ( FGF )、骨 钙 素 ( BGP )、 I 型 胶 原 羧 基 端 前 肽( PICP )、骨 特 异 性 碱 性 磷 酸 酶 ( BAP )水 平 均 高 于 对 照 组 ,抗 酒 石 酸 酸 性 磷 酸 酶 -5b ( TRACP-5b )低 于 对 照 组 ( P <0.05 );术后 1 个月两组视觉模拟评分( VAS )较术前均降低,且观察组低于对照组( P<0.05 );观察组并发症发生率为10.00% ,低于对照组的 20.51% ,但组间比较差异无统计学意义( P>0.05 )。 结论:前方入路髋关节置换术相较于外侧入路,前者治疗老年股骨颈骨折效果更 加 显 著 ,不 仅 能 提 高 髋 关 节 功 能 ,改 善 骨 代 谢 状 态 ,缓 解 疼 痛 程 度 ,还 具 有 一定的安全性。 |
| 英文摘要: |
| Objective: To discuss the effects of total hip arthroplasty the direct anterior approach versus lateral approach on hip function, pain and bony metabolic function in patients with femoral neck fracture. Methods: Seventy-nine elderly patients with femoral neck fracture underwent total hip arthroplasty in hospital between January 2020 and June 2022 were enrolled, and classified into different groups according to the surgical approaches. Observation group (n=40) received surgery via direct anterior approach, while control group (n=39) received surgery via lateral approach. Then the perioperative indexes, hip function, bony metabolic function, pain degree and complications were compared between two groups. Results: The operation time yielded no statistical difference between two groups (P＞0.05). Compared with the control group, the observation group had fewer postoperative drainage, less intraoperative blood loss, and shorter first time out of bed activity time, with statistical differences (P＜0.05). Compared with preoperative, Harris scales showed an increase in both groups at postoperative 1 month, 3 months and 6 months (P＜0.05). observation group scored higher on Harris scales than the control group at postoperative 1 month and 3 months (P＜0.05). At postoperative 1 month, serum levels of procollagen type ⅠN-terminal propeptide (PⅠNP), fibroblast growth factor (FGF), bone GLA-protein (BGP), procollagen type Ⅰcarboxy-terminal propeptide (PⅠCP) and bone-specific alkaline phosphatase (BAP) were higher in the observation group than those in the control group, and tartrate-resistant acid phosphatase-5b (TRACP-5b) level of the observation group was lower than that of control group (P＜0.05). VAS score at postoperative 1 month showed a reduction in both groups, and the observation group's VAS score lower than that of the control group(P＜0.05). The complication rate was 10.00% in the observation group, which had no statistical difference with 20.51% in the control group (P＞0.05). Conclusion: Compared with lateral approach, total hip arthroplasty via anterior approach makes more remarkable effects in patients with femoral neck fracture in terms of the improvement in hip function, amelioration in bone metabolism and the alleviation in pain, which has certain safety. |
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