摘要
目的探究改良外侧斜行小切口全髋关节置换(THR)对髋关节发育不良(DDH)并发骨性关节炎(OA)患者髋关节功能及疼痛程度的影响。方法收集2020年1月至2022年1月濮阳市油田总医院98例收治的DDH并发OA患者的病历资料,按手术方案不同分成A组(n=49)、B组(n=49)。B组接受后外侧Gibson入路THR治疗,A组接受改良外侧斜行小切口THR治疗。对比两组围术期指标、手术前后Harris髋关节功能评分、视觉模拟评分法(VAS)评分、免疫应激(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、创伤应激[去甲肾上腺素(NE)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、并发症发生率。结果A组切口长度较B组短,术中失血量较B组少(P<0.05);术后1个月、3个月A组Harris评分较B组高(P<0.05);A组术后3 d、7 d VAS评分较B组低(P<0.05);A组术后1 d、3 d CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较B组高(P<0.05);A组术后1 d、3 d血清NE、IL-6、CRP水平较B组低(P<0.05);A组并发症总发生率2.04%(1/49)较B组16.33%(8/49)低(P<0.05)。结论改良外侧斜行小切口THR治疗DDH并发OA患者可有效提高髋关节功能,减轻疼痛感,减少并发症发生,优化围术期指标,且对机体免疫及创伤应激影响小。
【Objective】To investigate the effect of modified lateral oblique small incision total hip arthroplasty(THR)on hip function and pain in patients with developmental dysplasia of the hip(DDH)complicated with osteoarthritis(OA).【Methods】The medical records of 98 patients with DDH complicated with OA in our hospital(from January 2020 to January 2022)were collected and divided into group A(n=49)and group B(n=49)according to different surgical plans.Group B received THR with posterolateral Gibson approach,and group A received THR with modified lateral oblique small incision.The perioperative indicators,Harris hip function score before and after surgery,Visual Analogue Scale(VAS)score,immune stress(CD3^(+),CD4^(+),CD4^(+)/CD8^(+)),traumatic stress[norepinephrine(NE),interleukin-6(IL-6),C-reactive protein(CRP)]levels,incidence of complications between the two groups were compared.【Results】The incision length of group A was shorter than that of group B,and the intraoperative blood loss was less than that of group B(P<0.05).The Harris score of group A was higher than that of group B at 1 and 3 months after operation(P<0.05).The VAS scores of group A at 3 day and 7 day after operation were lower than those of group B(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in group A at 1 day and 3 day after operation were higher than those in group B(P<0.05).The serum levels of NE,IL-6 and CRP in group A were lower than those in group B at 1 day and 3 day after operation(P<0.05).The total incidence of complications in group A was 2.04%(1/49),which was lower than that in group B[16.33%(8/49)](P<0.05).【Conclusion】The modified lateral oblique small incision THR in the treatment of DDH complicated with OA patients can effectively improve hip joint function,relieve pain,reduce complications,optimize perioperative indicators,and have little impact on immunity and traumatic stress.
作者
王沛
李原
杨光
刘涛
WANG Pei;LI Yuan;YANG Guang;LIU Tao(Department of Orthopedics,Puyang Oilfield General Hospital,Puyang,Henan 457000,China)
出处
《中国医学工程》
2023年第1期101-104,共4页
China Medical Engineering
