微创前入路全髋关节置换治疗老年股骨颈骨折

发布时间：2018-06-05 23:26

本文选题：全髋关节置换术 + 微创　；参考：《中国矫形外科杂志》2017年18期

【摘要】：[目的]比较直接前入路与后外侧入路人工全髋关节置换术治疗老年股骨颈骨折的短期临床疗效。[方法]2015年1月~2016年12月采用直接前方入路(direct anterior approach,DAA)技术行全髋关节置换术12例,其中女7例,男5例,年龄72~86岁,平均(78.70±3.60)岁。另按纳入标准随机抽取17例后外侧入路全髋关节置换术病例作为对照。[结果]DAA组手术切口(8.61±1.22)cm,比后外侧组(12.51±1.65)cm小;手术时间(95.02±10.14)min,比后外侧组(72.05±11.57)min长;术中出血量(155.01±26.03)ml,比后外侧组(220.03±32.53)ml少;术后引流量(109.11±15.52)ml,比后外侧组(158.97±21.82)ml少;差异均具有统计学意义(P0.05)。术后6个月髋关节Harris评分DAA组为(92.51±5.83)分,与后外侧组(91.88±6.32)分相比差异无统计学意义(P0.05)。[结论]DAA全髋关节置换,不仅切口小、术中出血量少,且利于置换术后早期功能锻炼。
[Abstract]:Objective: to compare the short-term clinical effect of direct anterior approach and posterolateral approach in the treatment of senile femoral neck fractures. [methods] from January 2015 to December 2016, 12 cases of total hip arthroplasty were performed with direct anterior approach-DAA technique, including 7 females and 5 males, with an average age of 78.70 卤3.60 years. In addition, 17 cases of total hip arthroplasty via posterolateral approach were randomly selected as control according to inclusion criteria. [results] the operative incision in the DAA group was 8.61 卤1.22 cm, which was smaller than that in the posterolateral group (12.51 卤1.65)cm), the operative time was 95.02 卤10.14 minutes, which was longer than that in the posterolateral group (72.05 卤11.57)min), the intraoperative bleeding volume was 155.01 卤26.03ml, less than that in the posterolateral group (220.03 卤32.53)ml), and the postoperative drainage volume was 109.11 卤15.52 11.57)min, less than that in the posterolateral group (158.97 卤21.82)ml). The Harris score of hip joint in the DAA group was 92.51 卤5.83 at 6 months after operation, and there was no significant difference between the DAA group and the posterolateral group (91.88 卤6.32). [conclusion] DAA total hip replacement is not only small incision, less intraoperative bleeding, but also beneficial to early functional exercise after replacement.
【作者单位】：天津市天津医院创伤骨科;
【基金】：天津市卫生行业重点攻关项目(编号:16KG143)
【分类号】：R687.4

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