后外侧入路小切口微创人工全髋关节置换术初步报告  

Preliminary report of minimally invasive surgery for total hip arthroplasty

作　　者：黄相杰[1] 高广凌[1] 谭远超[1] 周志高[1] 刘德忠[1] 焦明航[1] 

机构地区：[1]山东省文登整骨医院骨关节科

出　　处：《中国矫形外科杂志》2005年第21期1612-1614,共3页Orthopedic Journal of China

摘　　要：[目的]探讨后外侧入路小切口微创(minimallyinvasivesurgery,MIS)人工全髋关节置换的手术方法和初期临床治疗效果。[方法]采用后外侧入路MIS技术为68例72髋实施人工全髋关节置换术。股骨头坏死34例,其中双侧3例;股骨颈骨折25例;髋关节骨性关节炎9例,其中双侧1例。[结果]手术切口长7.5～11cm,平均9.28cm;术中出血量200～480ml,平均280ml;术后3个月时Harris评分平均为93分。在以往采用传统后外侧入路行人工全髋关节置换的病例中,选择病种、性别、年龄、术前Harris评分相近的患者68例72髋做为对照组,对两组进行对比:(1)切口MIS组明显短于传统组;(2)术中出血量少于传统组;(3)3个月时的Harris评分高于传统组(P<0.001)。[结论]采用MIS人工全髋关节置换技术,手术切口短,创伤小,出血少,术后功能恢复快,较传统的全髋置换术有明显的优势,但应有严格的手术指征和熟练的操作技术。[ Objective ] To report the surgical technique and preliminary therapeutic result of minimally invasive surgery （MIS） for total hip arthroplasty （THA） through a posterolateral approach. [ Method ] Seventy-two cases of 68 patients of total hip arthroplasty were performed through posterolateral mini-incision. There were 34 cases of femoral head necroses, 25 cases of femoral neck fractures and 9 cases of osteoarthritis. [ Result ] The average length of the incision was 9. 28 cm （ ranged, 7.5 - 11 cm） ; The average intraoperative blood loss was 280 ml （ ranged, 200 -480 ml）. According to the 3-month postoperative follow-up, all cases had an average Harris Hip Score of 93. The result was compared with another 68 cases with the similar gender, similar average age, and similar preoperative Harris Hip Score which accepted traditional treating method. The patients in MIS group had shorter skin incision, less blood loss and significant improvement of Harris Hip Score after the 3 month follow-up （ P 〈 0. 001 ） . [ Conclusion ] MIS for THA treatment through posterolateral approach has the advantages of shorter skin incision, less tissue damage, less bh）od loss and quicker postoperative recovery. It brings obvious better result compared with cases using conventional incision, but it has to follow strict indications and high demanding for operative technique.

关 键 词：微创外科 髋关节 关节置换 小切口 人工全髋关节置换术 后外侧入路 微创 HARRIS评分 髋关节骨性关节炎 术中出血量 

分 类 号：R687.4[医药卫生—骨科学] R739.41[医药卫生—外科学]