直接前入路全髋关节置换治疗伸直型髋关节强直患者的效果

发布时间：2019-02-22 10:31

【摘要】：目的探讨直接前入路(DAA)全髋关节置换治疗伸直型髋关节强直的临床效果。方法 81例伸直型髋关节强直患者随机分为A组39例、B组42例,分别进行直接DAA全髋关节置换和后外侧入路全髋关节置换。纳入患者均为单侧置换(先置换严重侧),手术均由同一高年资主刀医师完成,记录患者切口长度、手术时间、术中出血量、术后引流量,住院时间、单拐行走时间、弃拐行走时间,术前、术后及随访期间采用Harris评分、VAS评价髋关节功能及疼痛程度,术后进行影像学评价,并收集相关并发症。结果患者均获随访,平均随访23.5个月;与B组比较,A组切口长度短,术中出血量、术后引流量少,住院时间、单拐行走时间及弃拐行走时间短,术后3 d VAS低,术后1、3个月Harris评分高(P均0.05)。两组手术时间、末次随访时VAS、Harris评分比较,P均0.05。A组并发症发生率低于B组(P0.05)。结论 DAA全髋关节置换应用于伸直型髋关节强直患者中能快速减轻其疼痛及提高髋关节功能,且能降低术后并发症发生风险。
[Abstract]:Objective to investigate the clinical effect of direct anterior approach (DAA) total hip replacement in the treatment of straight hip ankylosis. Methods Eighty-one patients with extensional hip ankylosis were randomly divided into group A (39 cases) and group B (42 cases). Direct DAA total hip replacement and posterolateral approach total hip replacement were performed respectively. All the patients were unilateral replacement (first replacement severe side). The operation was performed by the same senior surgeon. The length of incision, the time of operation, the amount of blood lost during operation, the drainage flow after operation, the time of hospitalization, the time of walking with single crutch were recorded. The walking time, preoperative, postoperative and follow-up Harris score, VAS evaluation of hip joint function and pain degree, postoperative imaging evaluation, and related complications were collected. Results all patients were followed up for an average of 23.5 months. Compared with group B, group A had shorter incision length, less intraoperative bleeding, less drainage, shorter hospitalization time, shorter walking time and abandoned walking time, lower VAS at 3 days after operation, and higher Harris score at 1 and 3 months after operation (all P < 0. 05). The time of operation and the VAS,Harris score at the last follow-up were lower in group A than in group B (P 0.05). Conclusion DAA total hip replacement can relieve pain and improve hip function and reduce the risk of postoperative complications in patients with extensional hip ankylosis.
【作者单位】：西南医科大学附属医院;
【分类号】：R687.4

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