| 陈 永,王 柯,李东辉,陈朝辉.生物型与水泥型人工股骨头置换治疗老年Evans Ⅲ ~ Ⅳ型股骨转子间骨折疗效对比[J].中国烧伤创疡杂志,2023,(6):464~467. |
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| 中文关键词: 生物型人工股骨头置换 Evans分型 水泥型人工股骨头置换 股骨转子间骨折 髋关节功能 |
| 英文关键词:Biotype artificial femoral head replacement Evans classification Cement artificial femoral head replacement Femoral intertrochanteric fracture Hip function |
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| 中文摘要: |
| 【摘要】 目的 对比分析生物型与水泥型人工股骨头置换治疗老年 Evans Ⅲ ~ Ⅳ型股骨转子间骨折的临床疗效。方法 选取 2018 年 2 月至 2021 年 3 月河南大学第一附属医院收治的 110 例老年 Evans Ⅲ ~ Ⅳ型股骨转子间骨折患者作为研究对象, 按照随机数表法将其随机分为生物组 (55 例) 和水泥组 (55 例), 生物组患者行生物型人工股骨头置换, 水泥组患者行水泥型人工股骨头置换, 对比观察两组患者手术相关指标、 临床疗效、Harris评分以及并发症发生情况。 结果 生物组患者手术时间、术后下床活动时间及住院时间均明显短于水泥组(t = 2.600、11.082、16.783, P = 0.011、P < 0.001、P < 0.001), 术中出血量、 术后引流量、 隐性失血量均明显少于水泥组 (t = 2.036、2.978、2.729, P = 0.044、0.004、0.007); 术后 3 个月, 生物组患者临床疗效明显优于水泥组 (Z = - 4.089, P < 0.001), Harris评分中的关节疼痛、功能、活动范围评分均明显高于水泥组 ( t =2.146、5.752、2.793, P = 0.036、P < 0.001、 P = 0.007); 术后随访 3 个月, 生物组患者并发症发生率与水泥组无明显差异 (χ2= 0.343, P = 0.558)。结论 与水泥型人工股骨头置换相比, 生物型人工股骨头置换更能明显提高老年 Evans Ⅲ ~ Ⅳ型股骨转子间骨折患者术后康复效果, 改善髋关节功能, 临床应用价值更高。 |
| 英文摘要: |
| 【Abstract】 Objective To compare the clinical efficacy of biotype and cement artificial femoral head replacement in the treatment of Evans Ⅲ - Ⅳ femoral intertrochanteric fracture in the elderly. Methods 110 elderly patients with Evans Ⅲ - Ⅳ femoral intertrochanteric fracture, admitted to The First Affiliated Hospital of Henan University from February 2018 to March 2021, were enrolled as research subjects to be divided into biotype group (n = 55) and cement group (n = 55) using the random number table. In the biotype group patients were treated with biotype artificial femoral head replacement while patients in the cement group were treated with cement artificial femoral head replacement. The surgery-related indicators, clinical efficacy, Harris scores, and occurrence of complications were compared between the two groups. Results The operation time, the time from operation to first-time ambulation, and length of stay in the biotype group were all remarkablyshorter than that in the cement group (t = 2.600, 11.082 and 16.783, P = 0.011, P < 0.001, P < 0.001), and intraoperative blood loss volume, postoperative drainage volume and hidden blood loss volume in the biotype group were all obviously less than that in the cement group ( t = 2.036, 2.978 and 2.729, P = 0.044, 0.004 and 0.007). At month 3 after surgery, the clinical efficacy in the biotype group was obviously better compared with the cement group (Z = - 4.089, P < 0.001). The Harris scores of patients in joint pain, function and range of motion were significant higher in the biotype group compared with the cement group (t = 2.146, 5.752 and 2.793, P = 0.036, P < 0.001, P = 0.007). The follow-up three months after surgery found no statistically significant difference between the two groups in terms of the incidence of complications (χ2= 0.343, P = 0.558). Conclusion In the treatment of Evans Ⅲ - Ⅳ femoral intertrochanteric fracture in the elderly, biotype artificial femoral head replacement, compared with cement artificial femoral head replacement, can realize better postoperative rehabilitation effect, and is more effective in improving hip joint functions, presenting much high value of clinical application. |
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