直接前入路全髋关节置换术与常规后外侧入路全髋关节置换术治疗髋臼发育不良的疗效对比

发布时间：2018-04-11 11:29

本文选题：发育性髋关节发育不良 + 直接前入路人工髋关节置换　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:探讨直接前入路全髋关节置换术(DAA)及常规后外侧入路全髋关节置换术(PLA)两种术式治疗成人髋关节发育不良继发骨性关节炎(Crowe分型I-II型)的近期临床疗效及其临床差异性。方法:对本研究中因患先天性髋臼发育不良继发骨性关节炎在江苏省中医院接受直接前入路全髋关节置换术和常规后外侧入路全髋关节置换术的患者各10例(DAA组10例,PLA组10例)进行完整的术后随访。所有手术均由同一手术者完成。PLA组平均随访时间为9.3个月,DAA组平均随访时间8.6个月,均获得了较为完整的术后随访。应用SPSS16.0统计软件进行统计分析并比较两组患者手术前后Harris评分、失血量、术后血红蛋白下降水平及脱位率等数据。结果:DAA组和PLA组疗效均令人满意,至末次随访时所有患者均未出现感染、假体松动等术后并发症。两组患者术前Harris评分并无明显差异(PLA组:55.7±2.75,DAA组:56.1 土2.81,Z=-0.306,P0.05)。随访结果表明,两组患者术后Harris评分均较术前明显改善(PLA组:术前 55.7±2.75,术后 74.2±4.71,P0.05;DAA组:术前 56.1±2.81,术后83.2土4.29,P0.05)。与PLA组相比,DAA组术后随访结果Harris评分较高(PLA组:74.2±4.71,DAA 组:83.2±4.29,P0.05),出血量较少(PLA 组:256.00±74.72,DAA 组:167.50±32.25,P0.05),术后血红蛋白下降较少(PLA 组:29.30±12.88,DAA组:15.90±8.53,P0.05),术后脱位率低(PLA组:脱位1人;DAA组:无脱位)。DAA组患者术后髋关节Harris评分、脱位率、出血量、血红蛋白下降量均优于PLA组。结论:对于髋关节发育不良继发骨性关节炎(Crowe分型I-II型)患者来说,DAA具有创伤小、出血少、脱位率低、功能恢复快、早期关节活动度更优等优点。
[Abstract]:Objective: to investigate the clinical efficacy and clinical difference of direct anterior approach total hip replacement (DAA) and conventional posterolateral approach total hip replacement (I-II) in the treatment of adult hip dysplasia secondary osteoarthritis (Osteoarthritis).Methods: ten patients with osteoarthritis secondary to congenital acetabular dysplasia received direct anterior approach total hip replacement and routine posterolateral approach total hip replacement in Jiangsu Provincial Hospital of traditional Chinese Medicine (Jiangsu Provincial Hospital of traditional Chinese Medicine).10 cases of PLA group (n = 10) were followed up completely.All the operations were performed by the same person. The average follow-up time of PLA group was 9.3 months and the average follow-up time of DAA group was 8.6 months.The data of Harris score, blood loss, hemoglobin level and dislocation rate before and after operation were analyzed by SPSS16.0 software and compared between the two groups.Results the curative effect of the two groups was satisfactory. No infection, loosening of prosthesis and other postoperative complications were found in all the patients at the last follow-up.There was no significant difference in preoperative Harris score between the two groups.The follow-up results showed that the postoperative Harris scores in both groups were significantly improved compared with those before operation: 55.7 卤2.75 preoperatively, 74.2 卤4.71 P0.05A, 56.1 卤2.81 preoperatively and 83.2 卤4.29p 0.05m postoperatively.Harris score of hip joint after operation,The rate of dislocation, the amount of bleeding and the decrease of hemoglobin were better than those of PLA group.Conclusion: for the patients with secondary osteoarthritis with dysplasia of hip (I-II type), it has the advantages of less trauma, less bleeding, lower dislocation rate, faster functional recovery and better early joint motion.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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