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目的：探讨人工关节置换与加压螺钉内固定治疗高龄骨质疏松性股骨颈骨折的疗效。方法：选取2010 年8 月至2013 年3 月我院收治的120 例高龄骨质疏松性股骨颈骨折患者，将所有患者随机分为人工置换组和内固定组两组，每组各60 例，内固定组采用加压螺钉内固定术治疗，人工置换组采取人工关节置换术治疗，评定两组患者的手术时间、术中出血量、下地时间、术后并发症发生率及末次随访时Harris 评分优良率。结果：人工置换组手术时间及术中出血量分别为（124.8± 16.7）min、（369.2± 99.7） ml，明显高于内固定组的（73.5± 15.1）min、（78.4± 25.6）ml；但人工置换组术后下地时间为（15.3± 4.8）d，明显低于内固定组的（40.2± 7.5）d；人工置换组与内固定组患者术后并发症的发生率分别为20%、66.7%，人工置换组明显低于内固定组，其中，泌尿系褥疮的组间差异最为显著；末次随访时Harris 评分优良率，相比于内固定组的61.67%，人工置换组为78.33%，明显偏高。差异有统计学意义（P<0.05）。结论：加压螺钉内固定术和人工关节置换术在治疗高龄骨质疏松性股骨颈骨折方面各有优劣，对于能够耐受人工关节置手术且经济条件好的的老年患者而言，采用人工关节置换术治疗，疗效更佳。

英文摘要:

Objective: To investigate arthroplasty with compression screw fixation elderly osteoporotic femoral neck fractures.Methods:August 2010 to March 2013 in our hospital 120 elderly patients with osteoporotic femoral neck fracture were selected, all patients were randomly divided into artificial replacement group and internal fixation group two groups, each 60 cases, compression screw fixation group with internal fixation, artificial replacement arthroplasty group taking the treatment, patients were assessed operative time, blood loss, ambulation time, postoperative complications and final follow-up Harris score excellent rate. Results:in artificial replacement group operation time and blood loss were 124.8 ± 16.7 (min), 369.2± 99.7 (ml), significantly higher than the internal fixation group 73.5± 15.1 (min), 78.4± 25.6 (ml); it artificial replacement postoperative ambulation time was 15.3± 4.8 (d), significantly lower than the internal fixation group 40.2 ± 7.5 (d); artificial replacement group and internal fixation group of patients the incidence of postoperative complications was 20%, 66.7 %, artificial replacement group was significantly lower than internal fixation group, in which urinary bedsores most significant difference between the groups; final follow-up Harris score excellent rate, compared to 61.6%of the fixation group, artificial replacement group was 76.7%, significantly high. Difference was statistically significant (P<0.05). Conclusion:compression screw fixation and arthroplasty in the treatment of elderly osteoporotic femoral neck fractures have their own advantages and disadvantages, set for artificial joints can withstand surgery and good economic conditions in elderly patients, the use of artificial arthroplasty for better efficacy.

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