改良前外侧入路半髋置换治疗粗隆间骨折的临床研究  

Clinical study on hemiarthroplasty in treating intertrochanteric fractures through modified anterolateral approach

作　　者：陈庆华[1] 冯宗权[2] 熊廷亮[1] 马俭凡 

机构地区：[1]广东医学院附属台山医院,529200 [2]佛山市中医院

出　　处：《齐齐哈尔医学院学报》2015年第23期3443-3446,共4页Journal of Qiqihar Medical University

摘　　要：目的通过比较半髋关节置换术改良前外侧入路与后外侧入路的临床疗效,探讨改良前外侧入路半髋关节置换治疗老年性不稳定型粗隆间骨折的优越性。方法 90例108髋随机分为两组,前外侧组(ASA组)56髋,行改良前外侧入路半髋关节置换术;后外侧组(PSA组)52髋,行后外侧入路半髋关节置换术;术后比较两组的手术时间、出血量、输血量、住院时间、术后关节Harris评分、疼痛评分(VAS)、并发症发生率、翻修率,死亡率等。结果改良ASA组手术时间、术中出血量,输血量,住院时间均显著低于PSA组(P<0.05),两组手术在关节Harris评分、疼痛评分(VAS)、并发症发生率、翻修率、死亡率方面无显著差异;术后假体脱位方面,ASA组为0,而PSA组有3例。结论选择改良前外侧入路行半髋关节置换术治疗不稳定粗隆间骨折较后外侧入路手术时间短,术中出血量少,住院时间短,术后无关节脱位,综合疗效优于PSA半髋关节置换术。Objective To explore the superiority of hemiarthroplasty in the treatment of senile unstable intertrochanteric fractures by modified anterolateral approach,through comparing the clinical efficacy of modified anterolateral approach and posterolateral approach. Methods 108 hips of 90 cases were randomly divided into two groups. 56 hips of anterolateral group（ ASA group） underwent modified anterolateral approach hemiarthroplasty. 52 hips of posterolateral group（ PSA Group） underwent posterolateral approach hemiarthroplasty. Operative time,blood loss,blood transfusion,duration of hospital stay,Harris score,Visual Analogue Scale（ VAS）,the incidence of complications,revision rate and mortality of the two groups were compared. Results Operative time,blood loss,blood transfusion and hospitalization time in improved ASA group were significantly lower than in that in PSA group（ P〈0. 05）. Differences of Harris score,VAS,the incidence of complications,revision rate and mortality between the two groups have no statistically significant. None dislocation of the prosthesis occurred after operation in ASA group while PSA group had three cases. Conclusions Treating senile unstable intertrochanteric fractures by using modified anterolateral approach arthroplasty has the advantages including shorter operative time, less blood loss, shorter hospital stay, the less postoperative dislocations. The comprehensive effectiveness is better than posterolateral approach.

关 键 词：改良 前外侧入路 粗隆间骨折 半髋关节置换术 

分 类 号：R687.4[医药卫生—骨科学]