直接前入路与后入路初次全髋关节置换术的疗效比较

发布时间：2018-07-29 10:25

【摘要】：目的比较直接前入路与后入路行初次全髋关节置换术(THA)的临床疗效与并发症。方法回顾性分析自2010-01—2013-01符合选择标准的171例初次全髋关节置换术患者的临床资料。根据手术入路不同,将患者分为前入路组(采用直接前入路行TKA)和后入路组(采用后入路行THA)。比较2组手术时间、出血量、切口长度、住院天数、臼杯外展角及前倾角、股骨柄中置率、疼痛视觉模拟VAS评分、UCLA评分及Harris髋关节评分及术后并发症。结果所有患者获得平均48.9(24~60)个月随访。2组手术时间、失血量、切口长度、臼杯外展角、臼杯前倾角、股骨柄中置率、及术后并发症发生率等比较,差异均无统计学意义(P0.05)。与后入路组相比,前入路组住院时间较短(P0.05)、术后第1天VAS评分较低(P0.05)、术后6周时UCLA评分及HHS评分较高(P0.05),但在之后随访中2组VAS、UCLA评分及HHS评分相似,差异无统计学意义(P0.05)。结论直接前入路行THA术后早期疗效优于后入路,但术后晚期2种入路具有相似的临床疗效。
[Abstract]:Objective to compare the clinical effects and complications of primary total hip arthroplasty (THA) by direct anterior approach and posterior approach. Methods the clinical data of 171 primary total hip replacement patients who met the selection criteria from 2010-01 to 2013-01 were retrospectively analyzed. According to different surgical approaches, patients were divided into anterior approach group (direct anterior approach TKA) and posterior approach group (THA). Via posterior approach group). The operation time, bleeding volume, incision length, length of hospital stay, acetabular cup abduction angle and anteversion angle, femur stalk median rate, pain visual simulation VAS score, Harris hip joint score and postoperative complications were compared between the two groups. Results there was no significant difference in the average operation time, blood loss, incision length, acetabular cup outreaching angle, acetabular cup anteversion angle, femoral stalk median rate and postoperative complication rate in all patients (P 0.05). Compared with the posterior approach group, the hospitalization time of the anterior approach group was shorter (P0.05), the VAS score was lower on the first day after operation (P0.05), the UCLA score and HHS score were higher at 6 weeks after operation (P0.05), but in the follow-up the two groups had similar VAS-UCLA score and HHS score, the difference was not statistically significant (P0.05). Conclusion the early effect of direct anterior approach after THA is better than that of posterior approach, but the two approaches have similar clinical effect.
【作者单位】：莒县人民医院骨三科;
【分类号】：R687.4

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