直接前方入路应用于同期双髋置换中的早期疗效分析
发布时间：2019-06-20 07:37
【摘要】：目的对比分析直接前方入路(direct anterior approach,DAA)与后外侧入路应用于同期双髋置换的临床疗效,探讨DAA在同期双髋置换中的应用价值。方法回顾分析2010年6月—2015年11月采用DAA或后外侧入路行同期双髋置换的65例患者临床资料,其中采用DAA同期双髋置换34例(A组),采用后外侧入路同期双髋置换31例(B组)。两组患者性别、年龄、体质量指数、术前血红蛋白水平、病因、病程、术前Harris评分及疼痛视觉模拟评分(VAS)比较,差异均无统计学意义(P0.05),具有可比性。记录并比较两组患者切口长度、手术时间、术中出血量、总输血量、住院时间、术后早期并发症及手术前后Harris评分、VAS评分,采用简易Likert量表法进行患者满意度评价,并行影像学评价。结果 A组切口长度、手术时间、术中出血量、总输血量、住院时间均显著优于B组(P0.05)。两组患者均获随访,随访时间A组15~48个月,平均25.3个月;B组12~51个月,平均27.6个月。A组手术相关并发症发生率(10.29%)明显低于B组(19.35%)(χ~2=8.769,P=0.023)。除A组1髋髋臼前倾角大于正常值外,两组其余患者髋臼前倾角及外展角均在正常范围内。A、B组各1髋假体不稳定固定,其余股骨假体股骨距无明显骨质吸收,固定稳定。两组患者术后各时间点Harris评分及VAS评分均较术前显著改善(P0.05),术后组内各时间点间差异亦有统计学意义(P0.05)。A组术后1、3个月Harris评分及术后3 d VAS评分均显著优于B组(P0.05);但末次随访时两组上述评分比较差异均无统计学意义(P0.05)。根据简易Likert量表法评价患者满意度,A组综合满意度97.1%(33/34),B组为67.7%(21/31),两组比较差异有统计学意义(χ~2=10.343,P=0.001)。结论 DAA应用于同期双髋置换能显著改善患者疼痛、加速髋关节功能恢复及提高患者满意度,但临床应用中需严格把握适应证,预防早期并发症,其远期疗效有待进一步观察。
[Abstract]:Objective to compare the clinical efficacy of direct anterior approach (direct anterior approach,DAA) and posterolateral approach in double hip replacement at the same time, and to explore the value of DAA in double hip replacement at the same time. Methods the clinical data of 65 patients undergoing simultaneous double hip replacement by DAA or posterolateral approach from June 2010 to November 2015 were analyzed retrospectively. among them, 34 patients were treated with DAA at the same time as double hip replacement (group A) and 31 patients were treated with posterolateral approach at the same time as double hip replacement (group B). There was no significant difference in sex, age, body mass index, preoperative hemoglobin level, etiology, course of disease, preoperative Harris score and pain visual simulation score between the two groups (P 0.05). The incision length, operation time, intraoperative blood loss, total blood transfusion, hospitalization time, early postoperative complications, Harris score before and after operation, VAS score were recorded and compared between the two groups. The patient satisfaction was evaluated by simple Likert scale method, and the imaging evaluation was performed. Results the length of incision, operation time, intraoperative blood loss, total blood transfusion and hospitalization time in group A were significantly better than those in group B (P 0.05). The patients in group A were followed up for 15 times 48 months (mean 25.3 months) and group B (12 months 51 months, mean 27.6 months). The incidence of operative complications in group A (10.29%) was significantly lower than that in group B (19.35%) (蠂 ~ 2 鈮，
本文编号：2503047
[Abstract]:Objective to compare the clinical efficacy of direct anterior approach (direct anterior approach,DAA) and posterolateral approach in double hip replacement at the same time, and to explore the value of DAA in double hip replacement at the same time. Methods the clinical data of 65 patients undergoing simultaneous double hip replacement by DAA or posterolateral approach from June 2010 to November 2015 were analyzed retrospectively. among them, 34 patients were treated with DAA at the same time as double hip replacement (group A) and 31 patients were treated with posterolateral approach at the same time as double hip replacement (group B). There was no significant difference in sex, age, body mass index, preoperative hemoglobin level, etiology, course of disease, preoperative Harris score and pain visual simulation score between the two groups (P 0.05). The incision length, operation time, intraoperative blood loss, total blood transfusion, hospitalization time, early postoperative complications, Harris score before and after operation, VAS score were recorded and compared between the two groups. The patient satisfaction was evaluated by simple Likert scale method, and the imaging evaluation was performed. Results the length of incision, operation time, intraoperative blood loss, total blood transfusion and hospitalization time in group A were significantly better than those in group B (P 0.05). The patients in group A were followed up for 15 times 48 months (mean 25.3 months) and group B (12 months 51 months, mean 27.6 months). The incidence of operative complications in group A (10.29%) was significantly lower than that in group B (19.35%) (蠂 ~ 2 鈮，
本文编号：2503047
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