全髋关节置换术联合阿仑膦酸钠片对股骨颈骨折的疗效及对骨密度水平的影响
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篇名: 全髋关节置换术联合阿仑膦酸钠片对股骨颈骨折的疗效及对骨密度水平的影响
TITLE:
摘要: 目的:研究全髋关节置换术(THA)联合阿仑膦酸钠片对股骨颈骨折的疗效及对骨密度的影响。方法:将2014-2016年我院收治的98例股骨颈骨折患者根据随机数字表法分为观察组与对照组,各49例。两组患者均行THA治疗,对照组术后7 d进行常规抗骨质疏松治疗[钙尔奇D片(每片含钙600 mg/维生素D3 125 IU),口服,1片/次,1次/d;骨化三醇胶丸(每粒25 μg),口服,2粒/次,1次/d];观察组除进行常规抗骨质疏松治疗外,同时口服阿仑膦酸钠片(10 mg/次,1次/d),两组患者均连续给药3个月。分别于术后7 d、3个月、6个月采用Harris评分系统评估患者髋关节功能优良率;检测并比较两组患者假体周围7个兴趣区(ROI1~7)骨密度水平。结果:术后7 d、3个月、6个月对照组髋关节功能优良率分别为16.33%、40.82%、69.39%,观察组髋关节功能优良率分别为17.78%、73.33%、88.89%,术后7 d两组患者髋关节功能优良率比较差异无统计学意义(P>0.05),观察组术后3、6个月髋关节功能优良率高于对照组(P<0.05)。术后7 d 两组患者假体周围骨密度水平无明显差异(P>0.05)。与术后7 d比较,术后3、6个月两组患者ROI1、ROI6、ROI7区骨密度水平逐渐降低(P<0.05或P<0.01),ROI2、ROI3、ROI5区骨密度水平先降低后升高(P<0.05或P<0.01),ROI4区骨密度水平无明显变化(P>0.05);术后3个月两组患者各分区骨密度水平无明显差异(P>0.05),术后6个月观察组患者ROI1、ROI2、ROI3、ROI5、ROI6、ROI7区骨密度水平明显高于对照组(P<0.05或P<0.01)。结论:THA联合阿仑膦酸钠片并结合常规抗骨质疏松治疗,可提高股骨颈骨折患者的髋关节功能优良率,提高假体周围骨密度水平。
ABSTRACT: OBJECTIVE: To study therapeutic efficacy of total hip arthroplasty (THA) combined with Alendronate sodium tablets in the treatment of femoral neck fracture and its effects on bone mineral density (BMD). METHODS: A total of 98 patients with femoral neck fractures in our hospital during 2014-2016 were divided into observation group and control group by random digital table method, with 49 cases in each group. Both groups were treated with THA. 7 days after operation, control group was given routine anti-osteoporosis treatment [Gaierqi D tablets (containing 600 mg calcium/vitamin D3 125 IU in each tablet), p.o., one tablet/time, once a day; Calcitriol soft capsules (25 μg each pill, p.o., 2 pills/time, once a day)]. Observation group was additionally given Alendronate sodium tablets (10 mg/time, once a day) on the basis of control group. Both groups were treated for consecutive 3 months. The hip function excellent rate was evaluated by using Harris scoring system at 7 days, 3 months and 6 months after operation. The periprosthetic 7 cases of egion interest (ROI1-7) BMD were detected and compared between 2 groups. RESULTS: The excellent rate of hip joint function in the control group were 16.33%, 40.82%, 69.39% 7 days, 3 months, 6 months after operation, respectively; those of observation group were 17.78%, 73.33%, 88.89% respectively. There was no statistical significance in the excellent rates of hip joint function between 2 groups 7 days after operation (P>0.05). The excellent rate of hip joint function in observation group was higher than control group 3 months and 6 months after operation (P<0.05). There was no significant difference in periprosthetic BMD between 2 groups 7 days after operation (P>0.05). Compared with 7 days after operation, BMD of ROI1, ROI6 and ROI7 in 2 groups were decreased gradually 3 months and 6 months after operation (P<0.05 or P<0.01). BMD of ROI2, ROI3 and ROI5 decreased first and then increased (P<0.05 or P<0.01). There was no significant change in BMD of ROI4 (P>0.05). There was no significant difference in BMD of each area between 2 groups 3 months after operation (P>0.05). BMD of ROI1, ROI2, ROI3, ROI5, ROI6 and ROI7 in observation group were significantly higher than control group 6 months after operation (P<0.05 or P<0.01). CONCLUSIONS: THA combined with Alendronate sodium tablets and conventional anti-osteoporosis treatment can improve the excellent rate of hip joint function in patients with femoral neck fracture and the level of periprosthetic BMD.
期刊: 2018年第29卷第9期
作者: 刘克春,刘世珑,刘国胜,赵雪圆
AUTHORS: LIU Kechun,LIU Shilong,LIU Guosheng,ZHAO Xueyuan
关键字: 全髋关节置换术;阿仑膦酸钠片;股骨颈骨折;疗效;骨密度
KEYWORDS: Total hip arthroplasty; Alendronate sodium tablets; Femoral neck fracture; Therapeutic efficacy; Bone mineral density
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