SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折短期临床疗效

发布时间：2018-02-03 13:16

本文关键词： 股骨颈骨折 SuperPATH入路改良Hardinge入路髋关节置换微创手术　出处：《国际骨科学杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折短期临床疗效。方法 2013年8月至2015年10月,收集44例80岁及以上股骨颈骨折行髋关节置换术(全髋关节置换术4例,人工股骨头置换术40例)患者资料,其中21例采用SuperPATH入路,23例采用改良Hardinge入路。将人工股骨头置换术患者分为SuperPATH组20例,改良Hardinge组20例,比较两组手术时间、出血量、并发症、疼痛视觉模拟评分(VAS)、Harris髋关节评分和患者满意度。结果 SuperPATH组手术时间、切口关闭时间均短于改良Hardinge组,前者分别为(67.4±9.5)min和(12.9±2.7)min,后者分别为(71.9±5.1)min和(25.0±3.8)min。SuperPATH组术后1、5 d血红蛋白(Hb)分别下降(12.6±3.7)g/L和(15.2±3.8)g/L,下降值低于改良Hardinge组,后者分别为(16.9±4.5)g/L和(21.0±5.3)g/L。SuperPATH组术后6周内疼痛程度轻于改良Hardinge组,但术后3、6个月两组疼痛差异无统计学意义;SuperPATH组术后3个月Harris髋关节评分明显优于改良Hardinge组,分别为(70.4±4.8)分和(61.9±7.1)分,但两组术后6个月Harris髋关节评分差异无统计学意义;SuperPATH组患者满意度均优于改良Hardinge组。结论 SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折可获得良好的短期临床疗效。
[Abstract]:Objective to investigate the short-term clinical effect of SuperPATH approach for the treatment of senile femoral neck fractures. Methods from August 2013 to October 2015. The data of 44 patients with femoral neck fracture over 80 years old who underwent hip arthroplasty (total hip replacement in 4 cases and artificial femoral head replacement in 40 cases) were collected. Among them, 21 cases were treated with SuperPATH approach. 23 patients were divided into SuperPATH group (n = 20) and modified Hardinge group (n = 20) by modified Hardinge approach. Blood loss, complications, visual analogue score of pain, hip joint score and patient satisfaction in SuperPATH group. The incision closure time was shorter than that in the modified Hardinge group, which was 67.4 卤9.5 minutes and 12.9 卤2.7 minutes, respectively. The latter were 71.9 卤5.1 min and 25.0 卤3.8 min 路SuperPATH respectively. At 5 days, the HB decreased by 12.6 卤3.7g / L and 15.2 卤3.8g / L, respectively, which were lower than those of the modified Hardinge group. The latter were 16.9 卤4.5g / L and 21.0 卤5.3g / L, respectively, and the pain degree was less in the group of modified Hardinge within 6 weeks after operation than in the group of modified Hardinge. But there was no significant difference in pain between the two groups 3 and 6 months after operation. The score of Harris hip joint in SuperPATH group was significantly better than that in modified Hardinge group 3 months after operation, which was 70.4 卤4.8 and 61.9 卤7.1, respectively. However, there was no significant difference in Harris hip score between the two groups 6 months after operation. Conclusion the patients satisfaction of SuperPATH group is better than that of modified Hardinge group. The short-term clinical effect of SuperPATH approach for the treatment of senile femoral neck fracture is good.
【作者单位】：复旦大学附属华山医院骨科;
【分类号】：R687.4
【正文快照】： 髋关节置换术包括全髋关节置换术和人工股骨头置换术。与全髋关节置换术相比,人工股骨头置换术治疗高龄老年股骨颈骨折具有创伤小、手术时间短和关节稳定性好等优点[1-2]。改良Hardinge入路是髋关节前外侧入路,它通过切开部分臀中肌、臀小肌和关节囊显露关节,是髋关节置换术的

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