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王 昶.不同入路路径人工髋关节置换治疗老年股骨颈骨折的效果及对血清BALP、DPD、TRACP5b水平的影响[J].中国现代医生,2021,59(1):65-68
不同入路路径人工髋关节置换治疗老年股骨颈骨折的效果及对血清BALP、DPD、TRACP5b水平的影响
Efficacy of artificial hip replacement with different approaches on femoral neck fracture in the elderly and its impacts on serum levels of BALP,DPD and TRACP5b levels
  
DOI:
中文关键词:  人工髋关节置换术  老年人  股骨颈骨折  骨代谢  髋关节功能
英文关键词:Artificial hip replacement  The elderly  Femoral neck fracture  Bone metabolism  Hip joint function
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作者单位
王 昶 中国人民解放军联勤保障部队第九六三医院骨科黑龙江佳木斯 154002 
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中文摘要:
      目的 探讨直接前侧入路与传统后外侧入路行人工髋关节置换治疗老年股骨颈骨折的效果及对血清骨特异性碱性磷酸酶(BALP)、脱氧吡啶酚(DPD)、抗酒石酸盐酸性磷酸酶异构体(TRACP5b)水平的影响。方法 选取我院自2018 年1 月至2019 年1 月收治的75 例老年股骨颈骨折患者,按照随机数字表法分为对照组37 例、观察组38 例。对照组采用传统后外侧入路人工髋关节置换术,观察组采用直接前侧入路人工髋关节置换术,比较两组一般手术情况、骨代谢指标、髋关节功能及术后并发症。结果 观察组切口长度小于对照组,术后住院时间短于对照组(P<0.05);术后3 个月,两组血清BALP 水平升高,DPD、TRACP5b 水平下降,且观察组血清BALP 水平高于对照组,DPD、TRACP5b 水平低于对照组(P<0.05);观察组术后3 d、术后1 周、术后1 个月的Harris 评分高于对照组(P<0.05);观察组术后并发症总发生率为13.16%,低于对照组的35.14%(P<0.05)。结论 直接前侧入路人工髋关节置换治疗老年股骨颈骨折切口小,术后住院时间短,且可改善患者骨代谢,促进髋关节功能恢复,减少术后并发症发生。
英文摘要:
      Objective To investigate the efficacy of artificial hip replacement through direct anterolateral approach and conventional posterolateral approach on femoral neck fracture in the elderly,and its impacts on serum levels of bonespecific alkaline phosphatase(BALP),deoxypyridinoline(DPD) and tartrate-resistant acid phosphatase 5b(TRACP5b).Methods A total of 75 elderly patients with femoral neck fracture admitted to our hospital from January 2018 to January 2019 were selected and divided into the control group(n=37) and the observation group(n=38).The control group was treated with artificial hip replacement through conventional posterolateral approach,while the observation group was treated with artificial hip replacement through direct anterolateral approach.The general operation condition,bone metabolism index,hip joint function and postoperative complications were compared between the two groups.Results The incision length and postoperative hospitalization time in the observation group were shorter than those in the control group(P<0.05).Three months after operation,the serum BALP levels in the two groups both increased,while the levels of DPD and TRACP5b decreased.The serum BALP level in the observation group was higher than that in the control group,while the levels of DPD and TRACP5b were lower than those in the control group(P<0.05).Harris scores in the observation group were higher than those in the control group at 3 days,1 week and 1 month after operation(P<0.05).The overall incidence of postoperative complications in the observation group was 13.16%,which was lower than 35.14%in the control group(P<0.05).Conclusion Direct anterior approach artificial hip replacement for elderly patients with femoral neck fracture has the advantages of small incision and short postoperative hospitalization time.Meanwhile,it improves bone metabolism of patients,promotes recovery of hip joint function and reduces the incidence of postoperative complications.
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