保留关节囊的前外侧肌间隙入路微创全髋临床疗效分析

发布时间：2019-04-02 06:44

【摘要】：目的探讨保留关节囊的慕尼黑骨科医院前外侧肌间隙入路(OCM)微创全髋与传统髋关节置换的临床疗效对比。方法2009年1月—2014年1月于该院行髋关节置换术患者106例106髋,其中采取OCM入路微创全髋术53例53髋,传统髋关节置换术53例53髋,分析比较两组患者手术时间、术中出血量、术前术后血红蛋白(HB)、红细胞比容(HCT)、肌酸激酶(CKNAC)、C-反应蛋白(CRP)、手术切口长度、术后前3 d引流量、术后输血量、术后下地时间,术后并发症,术后1个月和1年Harris评分(HHS)及骨性关节炎指数评分(WOMAC),影像学评价,住院时间。结果术后随访7~36个月,平均21.2个月,微创组手术切口长度、手术出血量、术后引流量、术后输血前血红蛋白、术后输血前红细胞比容、术后输血量、术后CK-NAC、CRP、下地活动时间,住院时间明显优于常规组(P0.05);两组术后影像学评价、术后1个月和1年HHS及WOMAC评分无统计学意义(P0.05)。结论保留关节囊的OCM入路微创全髋置换术相对于传统的全髋置换术有软组织创伤小,术后疼痛小,围手术期出血少,恢复快,术后能早期下床行功能锻等优点。但OCM入路的微创全髋操作相对复杂,应由具有一定临床经验的医生和相应条件的医院开展。
[Abstract]:Objective to evaluate the clinical efficacy of (OCM) minimally invasive total hip arthroplasty and traditional hip arthroplasty in Munich Orthopaedic Hospital. Methods from January 2009 to January 2014, 106 patients (106 hips) underwent hip arthroplasty in our hospital. Among them, 53 cases (53 hips) underwent minimally invasive total hip arthroplasty through OCM approach and 53 cases (53 hips) underwent traditional hip arthroplasty. The operative time and intraoperative bleeding were analyzed and compared between the two groups. The operative incision length of hemoglobin (HB), corpuscular volume (HCT), creatine kinase (CKNAC), C-reactive protein (CRP), was measured. One month and one year after operation, the Harris score (HHS) and osteoarthritis index score (WOMAC), imaging evaluation, hospital stay. Results the follow-up period was 7-36 months (mean 21.2 months). In the minimally invasive group, the length of incision, the amount of bleeding, the postoperative drainage, the hemoglobin before transfusion, the hematocrit before transfusion, the volume of blood transfusion after operation, and the postoperative CK-NAC,CRP, in the minimally invasive group were significantly higher than those in the control group. The time of down-ground activity and hospitalization were significantly better than those of routine group (P0.05). There was no significant difference in HHS and WOMAC scores 1 month and 1 year after operation between the two groups (P0.05). Conclusion compared with the traditional total hip replacement, the minimally invasive total hip replacement with preserving the articular capsule has the advantages of less soft tissue trauma, less postoperative pain, less bleeding during perioperative period, rapid recovery, and early functional forging of the lower bed after operation. However, minimally invasive total hip operation via OCM approach is relatively complex and should be carried out by doctors with certain clinical experience and hospitals with corresponding conditions.
【作者单位】：安徽医科大学第一附属医院骨科;
【分类号】：R687.4

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