外侧小切口和普通切口高龄全髋置换术的疗效对比  

Comparison of primary total hip arthroplasty in elderly patients performed with a minimally invasive direct lateral approach versus the standard lateral approach

作　　者：袁晓伟[1] 李林[1] 李青松[1] 

机构地区：[1]延边大学附属医院骨关节科,133000

出　　处：《天津医药》2016年第3期271-273,共3页Tianjin Medical Journal

摘　　要：目的比较小切口和普通切口直接外侧入路在高龄患者人工全髋关节置换术（THA）中的临床疗效差异。方法 118例行THA的老年患者按所行术式的不同分为小切口组61例和普通组57例。术后随访时间15个月~3年,记录2组切口长度,手术时间,术中出血量,术后12 h引流量,输血人数,住院时间,首次下床时间,术后3、6个月和末次Harris评分及并发症的差异。结果小切口组切口长度、术中出血量、术后12 h引流量、输血人数、住院时间、首次下床时间低于普通组,而术后3个月Harris评分均高于普通组（P〈0.05）;2组患者术后切口均一期愈合,但小切口组术后并发症发生率低于普通组（3.28%vs 15.79%,P〈0.05）。结论与普通切口相比,小切口直接外侧入路THA治疗高龄髋关节疾病具有手术创伤小,住院时间短,术后并发症少,关节功能恢复快等优点,疗效满意。Objective To compare the curative effects between minimally invasive and standard direct approach of pri-mary total hip arthroplasty（THA） in elderly patients. Methods One hundred and eighteen geratic patients with hip diseasewere divided into minimally invasive group（n=61） and standard group（n=57）. All the patients were followed up from 15 months to 3 years. The length of incision, surgical duration, intraoperative blood loss, postoperative drainage, number ofblood transfusion, hospitalization time and the Harris hip scores were compared between two groups. Results The length ofincision, intraoperative blood loss, postoperative drainage, number of blood transfusion and hospitalization time were signifi-cantly lower in minimally invasive group than those in standard group, but the Harris hip scores were significantly higher 3months after the operation in minimally invasive group than those in standard group（P〈0.05）. First intention wound healingwas found in all patients in two groups. The postoperative complications were significantly lower in minimally invasive groupthan those in standard group（3.28% vs 15.79%, P〈0.05）. Conclusion Compared with standard incision of primary total hiparthroplasty, minimally invasive direct lateral approach has its advantages, including small surgical trauma, less hospitaliza-tion time, fewer complications, and which can help restore joint function quickly, making the curative effect satisfied in elderlypatients.

关 键 词：关节成形术 置换 髋 老年人 外科手术 微创性 治疗结果 预后 

分 类 号：R684.75[医药卫生—骨科学]