探讨老年股骨颈骨折患者行髋关节置换术后髋关节功能恢复的相关影响因素。

回顾性选取2015年1月至2020年10月济南市长清区人民医院收治的老年股骨颈骨折患者100例，所有患者均行髋关节置换术，并术后随访1个月。按照髋关节功能评分标准（Harris评分）判定患者术后髋关节功能恢复情况，并将其分为恢复良好组（67例）和恢复不良组（33例）。对两组患者临床基线资料进行单因素分析（t检验和χ²检验），并将其中有统计学意义的因素纳入多因素非条件Logistic回归分析模型筛选独立危险因素。

单因素分析结果显示，恢复不良组年龄≥70岁、合并内科疾病≥2种、导管留置时间≥24 h、手术时间≥2 h、术后下床活动时间≥7 d、苏醒期发生躁动、围术期下肢深静脉血栓的患者占比均高于恢复良好组（P<0.05），隐性失血量大于恢复良好组（P<0.05）；多因素分析结果显示，年龄≥70岁、合并内科疾病≥2种、隐性失血量较多、手术时间≥2 h、苏醒期发生躁动、围术期并发下肢深静脉血栓为影响患者髋关节置换术后髋关节功能恢复的危险因素（OR=1.324、1.392、1.436、1.531、1.478、1.454，P<0.05）。

年龄≥70岁、合并内科疾病≥2种、隐性失血量较多、手术时间≥2 h、苏醒期发生躁动、围术期并发下肢深静脉血栓均为影响老年股骨颈骨折患者髋关节置换术后髋关节功能恢复的危险因素，临床可及时采取有效措施进行防治，促进患者术后髋关节功能的快速恢复。

To explore the influencing factors for functional recovery of hip joint after hip replacement in elderly patients with femoral neck fracture.

100 elderly patients with femoral neck fracture admitted to Changqing People's Hospital of Jinan City during January 2015 and October 2020 were retrospectively selected. All patients received hip replacement, and were followed up one month after surgery. According to the Harris hip function score, the patients were divided into group with good recovery (67 cases) and group with poor recovery (33 cases). The clinical baseline data of the two groups were collected for univariate analysis, and the statistically significant factors were included in the multivariate unconditional Logistic regression analysis model to screen the independent risk factors.

Univariate analysis showed that, the proportions of patients aged 70 years or above, complicated with 2 or more medical diseases, catheter indwelling time≥24 hours, operation time≥2 hours, postoperative ambulation time≥7 days, agitation during recovery and perioperative deep venous thrombosis of lower extremity in the poor recovery group were higher than those in the good recovery group (P < 0.05), and the recessive blood loss was greater than that in the good recovery group(P < 0.05). Multivariate unconditional Logistic regression analysis showed that, age≥70 years, complicated with 2 or more medical diseases, big recessive blood loss, operation time≥2 hours, agitation during recovery and perioperative deep venous thrombosis of lower extremity were independent risk factors for hip function recovery after hip replacement in elderly patients with femoral neck fracture (OR=1.324, 1.392, 1.436, 1.531, 1.478 and 1.454, P < 0.05).

Age≥70 years, complicated with 2 or more medical diseases, big recessive blood loss, operation time≥2 hours, agitation during recovery and perioperative deep venous thrombosis of lower extremity are risk factors for functional recovery of hip joint after hip replacement in elderly patients with femoral neck fracture, and effective measures should be taken in time to promote the rapid recovery of hip function.