后外侧小切口入路与直接前侧入路微创全髋关节置换术的对比研究

发布时间：2018-11-04 14:21

【摘要】：[目的]对比研究后外侧小切口入路(posterolateral approach,PLA)与直接前入路(direct anterior approach,DDA)对全髋关节置换术(total hip arthroplasty,THA)患者术中及术后治疗效果的影响。[方法]选取2016年1月~2017年1月于本科行THA手术治疗的股骨颈骨折及股骨头坏死患者,共44例,根据手术入路方式不同将其分为DAA组和PLA组,其中DAA组21例21髋,PLA组23例23髋。统计两组患者的一般情况及手术切口长度、手术时间、术中出血量、术后输血例数和输血量、术后12周时关节功能恢复情况(Harris评分、步态僵硬)、髋周疼痛及关节脱位情况进行评估。[结果]两组手术时间差异无统计学意义(P0.05),DAA组切口长度、术中出血量、术后输血量及术后12周时Harris评分、步态僵硬及髋周疼痛情况优于PLA组,差异有统计学意义(P0.05)。[结论]DAA入路微创THA与传统手术入路相比,软组织损伤更小,术后恢复更快,术后短期内更具优势。
[Abstract]:[objective] to compare the effect of posterolateral small incision approach (posterolateral approach,PLA) and direct anterior approach (direct anterior approach,DDA) on the intraoperative and postoperative outcomes of total hip arthroplasty (total hip arthroplasty,THA). [methods] A total of 44 patients with femoral neck fracture and femoral head necrosis treated with THA from January 2016 to January 2017 were divided into DAA group and PLA group according to the operative approach. 21 cases (21 hips) in DAA group were divided into two groups. 23 cases (23 hips) in PLA group. The general condition, the length of incision, the time of operation, the amount of intraoperative bleeding, the number of cases of postoperative blood transfusion and the amount of blood transfusion, and the recovery of joint function (Harris score, gait stiffness) at 12 weeks after operation were analyzed. Perihip pain and dislocation were evaluated. [results] there was no significant difference in operative time between the two groups (P0.05) the length of incision, the amount of intraoperative bleeding, the amount of blood transfusion, the Harris score at 12 weeks after operation, gait stiffness and peri-hip pain in), DAA group were better than those in PLA group. The difference was statistically significant (P0.05). [conclusion] compared with the traditional surgical approach, the DAA approach with minimally invasive THA has less soft tissue injury, faster postoperative recovery and more advantages in the short term.
【作者单位】：徐州市中心医院骨创伤一科;
【分类号】：R687.4

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