小切口与传统切口在全髋关节置换术中的临床疗效分析  

Comparative study of clinical effect on the mini-incision and traditional total hip replacement

作　　者：梁胜根[1] 付朝华[1] 陈忠羡[1] 张敏 范全[1] 雷洪俊[1] 赵振东[1] 

机构地区：[1]中山大学附属江门医院骨科,广东江门529000

出　　处：《岭南现代临床外科》2007年第4期286-288,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的比较外侧小切口和传统Gibson切口在THR中临床效果。方法2002年6月～2005年9月,采用小切口(n=47)和传统Gibson切口(n=50)行THR97例。记录手术时间,切口长度,术中、术后的出血总量,髋臼外展角度,髋臼前倾角,术后第1、3、6个月及最后次Harris评分。结果小切口组的手术时间为84.0±17.4min,传统切口组为90.0±19.8min(P<0.05);小切口组出血量为365.5±73.5ml,传统切口组485.8±114.6ml(P<0.05);小切口组术后X线片髋臼前倾角为23.5±3.3°,传统切口组为22.8±3.2°小切口组外展角为;46.5±6.2°,传统切口组为46.8±6.6°P<0.05)。所有病人均获随访,平均随访19个月(12～30)。术后第1、3个月(随访时,小切口组的Harris评分为69.7±7.6、84.8±7.4分,传统切口组为57.4±7.3、70.6±7.3分(P<0.05);术后第6个月、末次随访时,小切口组的平均Harris评分分别为86.8±5.2、93.7±4.0分,传统切口组为84.0±4.8、92.2±4.0分(P>0.05)。结论在全髋关节置换术中,采用小切口手术较传统切口手术具有创伤小,出血少,术后功能恢复快等优点,值得临床推广使用。Objective To compare the clinical effect of lateral mini-incision with traditional Gibson incision on total hip replacement（THA）. Methods From June 2002 to March 2005 , Patients were treated with THR respectively through mini-incision surgery （MIS） （n=47）and traditional Gibson approach （n=50）. It was observed including operative time ,incision length ,blood loss, anteversion angle of acetabulum cup, abduction angle of acetabulum cup, the 1st 3rd 6th and last month pastopertive Harris hip score. Results Operative time for MIS group was 84.0±17.4min and 90.0±19.8 min for Gibson group（P〈0.05）, blood loss for MIS group was 365.5±73.5 ml and 485.8± 114.6ml for Gibson group, there was significant difference between two Groups（P〈0.05）. According to the postoperative x-ray ,the anteversion angle of cup was 23.5±3.3°for MIS group and 22.8±3.2° for Gibson group, the abduction angle of acetabulum cup for MIS group was 46. 5±6.2°and 46.8± 6.6°for Gibson group （P〈0.05）. All patients had been fellowed-up with an average of 19 months （range from 12 to 30） Harris hip score of MIS group was 69.7±7.6 and 84.8±7.4 and 57.4±7.3 and 70.6±7.3for Gibson group at the 1st 3rd month follow-up （P〈0.05）, At the 6th month and last follow-up, there were no significant difference （P 〉 0.05）. Conclusion Mini-incision has advantages of less invasive and blood loss, rapidly postoperative recovery of function in THR. It is worth popularizing in clinical treatment.

关 键 词：全髋关节置换 小切口 微创术 Gibson切口 

分 类 号：R681.6[医药卫生—骨科学]