摘要
目的分析比较前外侧入路和后外侧入路在人工全髋关节置换中的疗效,为临床手术入路的选择提供参考依据。方法对广西壮族自治区人民医院2006-08～2011-05全髋关节置换术患者进行回顾分析,选择符合条件的152例(161髋)纳入研究。其中髋关节传统后外侧入路手术79例(A组,82髋),髋关节改良前外侧入路手术73例(B组,79髋)。随访时间为15个月～5年,平均4.3年。统计分析患者的年龄、性别、诊断、身高、体重、体重指数、切口长度、术中失血量、手术时间、术后引流量、下床行走时间、住院日、术前后Harris评分、术后并发症等,应用SPSS16.0统计学软件对两组数据进行分析比较。结果 B组在手术时间、切口长度、术中失血量、术后引流量、住院日、术后下床行走时间等疗效指标均显著优于A组,差异有统计学意义(P<0.01);而在术后假体脱位、神经麻痹、术后Harris评分及术中术后骨折、深静脉血栓形成、假体松动并发症发生率等方面两组差异无统计学意义(P>0.05)。结论采用改良前外侧入路进行全髋关节置换术在早期减少术中术后出血量、缩短手术时间和住院日、降低术后并发症的发生率以及早期进行关节功能恢复锻炼等方面具有明显的优势。该手术方式降低了假体位置不当导致关节脱位的风险,减轻了患者的经济负担。在适应证相同的情况下,应优先考虑选择髋关节改良前外侧入路。
Objective To compare the efficacy between the modified anterolateral approach and the tradi- tional lateral approach in total hip arthroplasty to provide reference for clinical selection of surgical approaches. Methods From August 2006 to May 2011,161 hips of 152 patients received total hip arthroplasty were selected and ran- domly divided into two groups, including 79 hips of 73 patients treated by the modified anterolateral approach and oth- er 82 hips of 79 patients by the traditional lateral approach. The follow-up time lasted from 15 months to 5 years, with an average of 4. 3 years. The patient＇s age, sex, diagnosis, height, weight, body mass index, incision length, blood loss, operative time, postoperative drainage, the time off bed for walking, hospital stay, Harris score before and after surgery, postoperative complications etc. were recorded, and analysised by SPSS 16. 0 between the two groups. The numeration data were tested with ehi square test. The measurement data are tested with test. Results In tile modified anterolateral approach group, in the operative time, the incision length, blood loss, postoperative drainage, length of stay, the time off bed for walking were significantly lower than those in the traditional incision group （ P 〈 0.05 ）. There were no significant difference postoperative Harris hip score, fracture ＆ deep vein thrombosis, prosthetie loose- ning and other complications （P 〉 0. 05 ）. Conclusion The modified anterolateral approach for the total hip arthro- plasty reduced intraoperative and postoperative blood loss, shorterned operative time and hospital stay, lessened the risk of postoperative complications early recovered joint functional exercise. As well as it reduced the risk of surgical implant dislocation due to the improper location and the patients＇ financial burden. So in the ease of the same indica- tions, prior consideration should be given to the choice of anterolateral approach.
出处
《中国临床新医学》
2012年第12期1116-1120,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
广西卫生厅重点科研课题(编号:桂卫重200955)
关键词
改良前外侧入路
后外侧入路
全髋关节置换术
Modified anterolateral approach
Posterolateral approach
Total hip replacement
