摘要
目的:探讨微创直接前方入路(direct anterior approach,DAA)行髋关节置换术治疗老年人股骨胫骨折的近期效果。方法:纳入2018年8月-2020年6月江门市蓬江区中西医结合医院及江门市人民医院收治的60例股骨颈骨折患者,以随机数表法分两组,各30例。对照组行后外侧入路(PLA)术,观察组行DAA入路术。对比两组临床指标,比较术前、术后各时间点C反应蛋白(CRP)、肌酸激酶(CK)、视觉疼痛模拟(VAS)评分、Harris髋关节(Harris)评分、SF-36量表评估生活质量变化,统计两组并发症发生情况。结果:观察组术中出血量、切口长度、术后24 h引流量、开始负重时间、住院时间均优于对照组,差异有统计学意义(P<0.05);与术前比较,患者CRP、CK均升高,而VAS评分降低,观察组低于对照组,差异有统计学意义(P<0.05);术后各时间点患者的Harris评分及术后6个月生活质量各项评分均升高,观察组高于对照组,差异有统计学意义(P<0.05);两组并发症比较,差异无统计学意义(P>0.05)。结论:DAA入路行全髋节置换术治疗老年股骨颈骨折具有微创特点,对肌肉损伤小,疼痛轻微,有利于髋关节早期恢复,安全性高,预后良好。
Objective:To investigate the short-term effect of minimally invasive direct anterior hip arthroplasty(DAA)in the treatment of femoral tibial fractures in the elderly.Method:A total of 60 patients with femoral neck fracture admitted to the Pengjiang Integrated Traditional Chinese and Western Medicine Hospital of Jiangmen City and Jiangmen People’s Hospital from August 2018 to June 2020 were randomly divided into two groups,30 cases in each group.The control group was treated with posterolateral approach(PLA),and the observation group was treated with DAA.The clinical indexes,C-reactive protein(CRP),creatine kinase(CK),visual analogue scale(VAS)score,Harris hip score and SF-36 scale were compared between the two groups before and after operation,and the incidence of complications was analyzed.Result:The intraoperative blood loss,incision length,postoperative 24 h drainage,time of starting weight-bearing and hospital stay in the observation group were better than those in the control group(P<0.05);compared with the preoperative,the CRP and CK of the patients were increased,while VAS score decreased,which in the observation group were lower than those in the control group(P<0.05);the Harris score at all time points after operation and the quality of life scores 6 months after operation in the observation group were higher than those in the control group(P<0.05);there was no significant difference in complications between the two groups(P>0.05).Conclusion:DAA approach for total hip arthroplasty in the treatment of elderly femoral neck fractures has the characteristics of minimally invasive,less muscle damage,mild pain,which is conducive to the early recovery of hip joint,high safety and good prognosis.
作者
李灿辉
徐尉宁
黄海波
柯楚群
LI Canhui;XU Weining;HUANG Haibo;KE Chuqun(The Pengjiang Integrated Traditional Chinese and Western Medicine Hospital of Jiangmen City,Jiangmen 529000,China;不详)
出处
《中外医学研究》
2021年第23期21-24,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
江门市科技计划项目(2018F003)。
关键词
股骨颈骨折
直接前方入路
髋关节置换术
C反应蛋白
肌酸激酶
髋关节
生活质量
并发症
Femoral neck fracture
Direct anterior approach
Hip replacement
C-reactive protein
Creatine kinase
Hip joint
Quality of life
Complication
