摘要
目的研究经直接前入路和后外侧入路初次全髋关节置换术(THA)患者的临床疗效。方法选取2016年1月—2019年7月于安徽医科大学第二附属医院骨科行初次单侧全髋关节置换术285例患者的临床资料。其中采用直接前入路(DAA)患者100例作为DAA组,后外侧入路(PLA)患者185例作为PLA组。观察并分析两组患者失血量、手术时间等围手术期指标,VAS评分、Harris评分及髋关节活动(屈曲、后伸、内收、外展、内旋、外旋)等功能评价指标。结果DAA组失血总量、隐性失血量、隐性失血量占比小于PLA组(P<0.05),手术时间、直腿抬高时间短于PLA组(P<0.05)。两组患者不同时间点的Harris评分、VAS评分、ROM指标比较,经重复测量设计的方差分析,结果:(1)不同时间点Harris评分、VAS评分、ROM指标有差异(P<0.05);(2)两组患者Harris评分、VAS评分有差异(P<0.05),ROM指标无差异(P>0.05);(3)两组患者Harris评分、VAS评分变化趋势有差异(P<0.05),ROM指标变化趋势比较无差异(P>0.05)。结论采用DAA行初次单侧THA可有效降低围手术期的失血量、缩短手术时间、减少术后疼痛,有利于早期功能恢复。
Objective To compare the clinical efficacy of direct anterior approach(DAA)and posterolateral approach(PLA)in primary total hip arthroplasty(THA).Methods We collected and retrospectively analyzed the clinical data of 285 patients undergoing primary unilateral THA in our department from January 2016 to July 2019,including 100 cases of DAA and 185 cases of PLA.The blood loss,operative duration,Visual Analogue Scale(VAS)score,Harris Hip Score(HHS),and the range of motion(ROM)of hip joint(flexion,extension,adduction,abduction,internal rotation,and external rotation)were observed and analyzed.Results The total blood loss,hidden blood loss,and the percentage of hidden blood loss in DAA group were significantly less than those in PLA group(P<0.05).The operative duration and straight leg raise time were shorter in DAA group compared with PLA group(P<0.05).The repeated measures analysis of variance exhibited that:(1)The HHS,VAS score,and ROM of hip joint were different among time points(P<0.05);(2)There were differences in HHS and VAS score(P<0.05)rather than ROM of hip joint(P>0.05)between the groups;(3)The change trend of HHS and VAS score(P<0.05)instead of ROM of hip joint(P>0.05)differed between the groups.Conclusions Compared with PLA,applying DAA for primary unilateral THA can effectively reduce perioperative blood loss,shorten the operative duration and decrease postoperative pain,which is conducive to early functional recovery.
作者
白文艺
吴晗
吴一博
于浩然
吕浩
姚运峰
程文丹
Wen-yi Bai;HanWu;Yi-bo Wu;Hao-ran Yu;Hao Lv;Yun-feng Yao;Wen-dan Cheng(Department of Orthopedics,The Second Hospital of Anhui Medical University,Hefei,Anhui 230601,China)
出处
《中国现代医学杂志》
CAS
北大核心
2021年第20期18-23,共6页
China Journal of Modern Medicine
基金
中央领导地方科技基金资助项目(No:9101131201)。
关键词
全髋关节置换术
失血
手术
治疗结果
total hip arthroplasty(THA)
blood loss
therapeutic outcome
