小切口人工全髋关节置换术对GardenIV型股骨颈骨折患者髋关节功能及应激状态的影响

Effect of mini-incision total hip arthroplasty on hip joint function and stress status in patients with Garden IV femoral neck fracture

摘要:

目的 探讨小切口人工全髋关节置换术（THA）对股骨颈骨折患者髋关节功能及应激状态的影响。方法 选取2013年12月—2016年12月武汉市第四医院确诊的股骨颈骨折患者100例。依据治疗方法分为A组和B组，每组50例，A组给予后外侧入路THA治疗，B组给予后外侧小切口THA治疗。统计分析所有患者术中出血量、手术时间、术后引流量、住院时间、并发症、髋关节功能和术前术后皮质醇（COR）、促肾上腺皮质激素（ACTH）水平。结果 两组术中出血量、术后引流量、住院时间、并发症发生率比较，差异有统计学意义（P?<0.05），B组低于A组；但两组手术时间、关节功能优良率基本相同，差异无统计学意义（P?> 0.05）；两组术后COR、ACTH水平高于术前，但B组术后COR、ACTH水平低于A组（P?<0.05）。结论 小切口THA治疗股骨颈骨折的疗效确切，且可有效减少患者的手术创伤及术后应激反应，有利于减少患者并发症发生和身体恢复，值得临床作进一步推广。

Abstract:

Objective To discuss the effect of mini-incision total hip arthroplasty (THA) on joint function and stress stage in patients with femoral fracture. Methods Totally 100 patients with femoral fracture were selected from December 2013 to December 2016 in our Hospital, according to the treatment method, all patients were divided into group A and group B, 50 cases in each group. group A was given THA treatment, while group B was given small incision THA treatment, The intraoperative blood loss, operative time, postoperative drainage flow, hospital stay time, complication, joint function and preoperative, postoperative serum cortisol (COR), fasting blood glucose (ACTH) levels were statistically anylyzed. Results The intraoperative blood loss, postoperative drainage flow, hospital stay time, complication rate of group B were significantly lower than those of group A, the differences were statistically significant (P?< 0.05). but the operation time, joint function excellence rate of two groups were basically the same, which were not significant different (P?>?0.05). The postoperative serum COR and ACTH levels of group A and group B were significantly higher than those of the preoperative ones, and the postoperative serum COR and ACTH levels of group B were significantly lower than those of group A, the differences were statistically significant (P?