直接前方入路与后外侧入路在全髋置换术中的疗效比较

发布时间：2018-01-19 20:27

本文关键词： 直接前方入路全髋置换术疼痛髋关节功能　出处：《中国现代医学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的研究直接前方入路(DAA)在全髋置换术(THA)中的应用疗效及经验总结。方法共纳入156例首次THA患者,其中82例采用后外侧入路(PLA),74例采用DAA,对比临床疗效。结果两组的手术时间比较,差异无统计学意义(P0.05),DAA组的术中出血、术后引流时间和引流量减小,与PLA组比较,差异有统计学意义(P0.05)。两组围术期并发症发生率比较,差异无统计学意义(P0.05)。DAA组术后1、3和7 d疼痛评分低于PLA组,差异有统计学意义(P0.05)。DAA组的部分下地负重、完全负重时间和总住院时间较PLA组缩短,差异有统计学意义(P0.05)。DAA组术后1、3和6个月Harris髋关节功能评分高于PLA组,术后6个月DAA组髋关节功能优于PLA组,差异有统计学意义(P0.05)。结论 THA采用DAA手术创伤更小,疼痛减轻,早期功能锻炼时间缩短,髋关节功能改善更佳,有较好的应用安全性和有效性。
[Abstract]:Objective to study the efficacy and experience of direct anterior approach in total hip replacement (tha). Methods 156 patients with first THA were included. Among them, 82 cases were treated with posterior lateral approach and 74 cases were treated with DAA.The results showed that there was no significant difference in the operation time between the two groups (P 0.05). The intraoperative bleeding, postoperative drainage time and drainage volume decreased in DAA group, and the difference was statistically significant compared with that in PLA group (P 0.05). The incidence of perioperative complications in the two groups was higher than that in the control group (P < 0.05). There was no significant difference in pain scores between P0.05U 路DAA group and PLA group on the 3rd and 7th day after operation, and there was significant difference between the two groups. The time of complete weight loading and total hospitalization time were shorter than that of PLA group, and the difference was statistically significant. The score of hip function of Harris group was higher than that of PLA group at 1: 3 and 6 months after operation. The function of hip joint in DAA group was better than that in PLA group 6 months after operation, the difference was statistically significant (P 0.05). Conclusion the operation of DAA in THA is less traumatic and the pain is alleviated. Early functional exercise time is shortened, hip joint function is improved better, has good application safety and effectiveness.
【作者单位】：安徽医科大学附属省立医院骨二科;
【分类号】：R687.4
【正文快照】： 全髋置换术(total hip arthroplas,THA)是治疗股骨头坏死、骨关节炎和股骨近端不稳定性骨折的重要手术方法[1],常用手术入路有外侧和后侧,而直接前方入路(direct anterior approach,DAA)是真正意义上的微创,恢复快、疼痛轻[2]。不切断髋部任何肌肉即可显露髋关节,术后短期临床

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