| 骨水泥与生物型股骨假体治疗老年股骨颈骨折的临床疗效比较 |
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投稿时间：2016-05-20
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| 期刊信息：《中国骨伤》2016年，第29卷，第11期，第977-981页 |
| DOI：10.3969/j.issn.1003-0034.2016.11.002 |
| 基金项目: |
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中文摘要:
目的：研究比较骨水泥型与生物型股骨假体治疗老年骨质疏松性股骨颈骨折的早期固定效果和患者死亡率，探讨人工髋关节置换术中有关假体选择的问题。
方法：2012年1月至2014年12月，采用人工髋关节置换术治疗130例（130髋）老年骨质疏松性股骨颈骨折患者。根据假体固定类型分两组：骨水泥组72例，男26例，女46例，平均年龄（82.0±6.5）岁，Garden Ⅲ型32例，Ⅳ型40例，受伤至手术时间（5.5±3.3） d；生物型组58例，男19例，女39例，平均年龄（80.1±6.7）岁，Garden Ⅲ型21例，Ⅳ型37例，受伤至手术时间（5.4±2.1） d.所有患者出现患侧髋部肿胀、压痛、下肢轴向叩击痛及关节活动障碍。入院后进行ASA等级评价、心功能评估、手术治疗以及有效的术后随访。观察比较两组手术持续时间、术中出血量、住院时间、并发症发生率、死亡率、残余疼痛（VAS评分）和髋关节功能（Harris评分）.
结果：生物型组比骨水泥组手术持续时间短、术中出血量少（P<0.05）.围手术期骨水泥组2例（2.7%）患者死亡，而生物型组无患者死亡。128例患者术后均获得随访，随访时间平均22个月。骨水泥组随访期间比生物型组的并发症发生率和VAS评分低（P<0.05），Harris评分高（P<0.05）；两组患者随访期间死亡率没有明显差异（P>0.05）.
结论：采用骨水泥型假体治疗老年骨质疏松性股骨颈骨折的早期固定效果比生物型假体较好。术前ASA等级高或心肺功能较差的患者，可酌情选择生物型假体以降低围手术期患者死亡率。 |
| 【关键词】老年人 股骨颈骨折 关节成形术,置换,髋 骨水泥成形术 病例对照研究 |
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| Comparison of clinical outcome between cemented and biological femoral prosthesis for the treatment of senile femoral neck fracture |
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ABSTRACT
Objective: To study and compare the early fixed effect and mortality for cemented and biological femoral prosthesis in treatment of senile osteoporotic femoral neck fracture,and investigate the prosthesis choice in hip arthroplasty.
Methods: From January 2012 to December 2014,130 patients(130 hips) with osteoporotic femoral neck fracture were treated by hemiarthroplasty. According to the operation method the patients was divided into two groups: 72 cases in cemented group included 26 males and 46 females with an average age of (82.0±6.5) years old,32 cases were Garden Ⅲ and 40 cases were Garden Ⅳ,the average time from injury to operating was(5.5±3.3) days;58 cases in biological group included 19 males and 39 females with an average age of(80.1±6.7) years old,21 cases were Garden Ⅲ and 37 cases were Garden Ⅳ,and the average time from injury to operating was(5.4±2.1) days. Every patients were suffering from hip swelling,tenderness,axial taps lower limb pain and joint activities obstacles. ASA grade evaluation,heart function assessment,surgical treatment and postoperative follow-up effectively performed after admission. The operation duration,intraoperative blood loss,hospital stay,rate of complications,mortality,residual pain (VAS score) and hip function (Harris score) of two groups were observed and compared.
Results: Biological group received shorter operation time and less intraoperative blood loss than cemented group(P<0.05). Perioperative mortality was 2.7%(2 patients) in cemented group,and no one death in biological group. Finally,128 patients were follow-up for an average of 22 months. Complications and VAS score of cemented group was lower than that of biological group during follow-up(P<0.05),but Harris score was higher (P<0.05). There was no statistical difference in mortality between two groups during follow-up period(P>0.05).
Conclusion: The early fixed effect for the cemented prosthesis used in treatment of senile osteoporotic femoral neck fracture is better than biological stem. Some patients who with higher ASA grade or poor cardiopulmonary function can choose biological prosthesis in order to reduce perioperative mortality. |
| KEY WORDS Aged Femoral neck fractures Arthroplasty,replacement,hip Cementoplasty Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈善斌,刘智.骨水泥与生物型股骨假体治疗老年股骨颈骨折的临床疗效比较[J].中国骨伤,2016,29(11):977~981 |
| 英文格式: | CHEN Shan-bin,LIU Zhi.Comparison of clinical outcome between cemented and biological femoral prosthesis for the treatment of senile femoral neck fracture[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(11):977~981 |
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