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目的:观察平卧位不同入路全髋关节置换术(THA)治疗老年股骨颈骨折患者的效果。方法:抽取2018年2月至2019年12月于开封市中心医院接受THA治疗的符合条件的80例老年股骨颈骨折患者，按照随机数表法分为对照组和观察组，每组40例。全部患者均接受全髋关节置换术，且麻醉方式一致，对照组使用平卧位后外侧入路(PLA)方式，观察组使用平卧位直接前方入路(DAA)方式。记录并比较两组手术指标；采用视觉模拟评分法(VAS)评估术前及术后24 h、72 h、1个月、6个月的疼痛情况；术后患者均接受相同功能训练指导，并随访6个月，采用Harris髋关节功能评分(Harris评分)和巴氏指数(Barthel指数)评分分别评价两组术前、术后6个月髋关节功能和日常生活活动能力变化情况；随访期间，记录两组并发症。结果:观察组手术时间长于对照组，下地时间和住院时间短于对照组，术中出血少于对照组(n P<0.05)；两组术后24 h、72 h、1个月、6个月的VAS评分较术前逐渐降低，且观察组术后24 h、72 h、1个月VAS评分低于对照组(n P0.05)；术后6个月，两组Harris评分、Barthel指数评分均较治疗前升高，且观察组高于对照组(n P<0.05)；观察组总并发症发生率低于对照组(n P<0.05)。n 结论:与THA术中平卧位PLA方式比较，DAA方式更利于减少术中出血量，缩短患者下地和住院时间，且疼痛程度更轻微，髋关节功能恢复更好，日常生活活动能力更好，同时并发症发生风险较低，更利于患者良性预后。“,”Objective:To observe the effect of different approaches in supine position during total hip arthroplasty (THA) on elderly patients with femoral neck fracture.Methods:A total of 80 elderly patients with femoral neck fracture who were eligible and received THA treatment in Kaifeng Central Hospital from February 2018 to December 2019 were prospectively selected, they were divided into control group and observation group according to random number table method, with 40 cases in each group. All patients underwent total hip arthroplasty, and the anesthesia method was the same, the control group were treated with the posterolateral approach (PLA) in the supine position and the observation group was treated with the direct anterior approach (DAA) in the supine position. The operation indexes of the two groups were recorded and compared; visual analogue scale (VAS) was used to evaluate the pain before and 24 h, 72 h, 1 month and 6 months after operation; all patients received the same functional training and were followed up for 6 months, Harris hip score and Barthel index were used to evaluate the changes of hip joint function and activities of daily living of the two groups before and 6 months after operation; during the follow-up period, complications of the two groups were recorded.Results:The operation time of the observation group was longer than that of the control group, the ambulation time and hospitalization time were shorter than those of the control group, and the intraoperative bleeding was less than that of the control group (n P<0.05); the VAS scores at 24 h, 72 h, 1 month and 6 months after operation in both groups were gradually decreased compared with those before operation, and the VAS scores at 24 h, 72 h and 1 month after operation in the observation group were lower than those in the control group (n P0.05); 6 months after operation, Harris hip score and Barthel index score of the both groups were higher than those before treatment, and those of the observation group were higher than those of the control group (n P<0.05); the total complication rate of the observation group was lower than that of the control group (n P<0.05).n Conclusions:Compared with PLA in supine position during THA, DAA is more conducive to reduce intraoperative blood loss, shorten the time of ground and hospitalization of patients, and the degree of pain is milder, the function of hip joint is better, and the ability of activities of daily living is better, at the same time, the risk of complications is lower, which is more conducive to the benign prognosis of patients.