SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折短期临床疗效  

Short-term efficacy of hip arthroplasty through the SuperPATH approach for femoral neck fractures in very elderly patients

作　　者：黄钢勇[1] 夏军[1] 魏亦兵[1] 王思群[1] 吴建国[1] 陈飞雁[1] 陈杰[1] 石晶晟[1] 

机构地区：[1]复旦大学附属华山医院骨科,200040

出　　处：《国际骨科学杂志》2016年第5期331-336,共6页International Journal of Orthopaedics

摘　　要：目的探讨SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折短期临床疗效。方法 2013年8月至2015年10月,收集44例80岁及以上股骨颈骨折行髋关节置换术(全髋关节置换术4例,人工股骨头置换术40例)患者资料,其中21例采用SuperPATH入路,23例采用改良Hardinge入路。将人工股骨头置换术患者分为SuperPATH组20例,改良Hardinge组20例,比较两组手术时间、出血量、并发症、疼痛视觉模拟评分(VAS)、Harris髋关节评分和患者满意度。结果 SuperPATH组手术时间、切口关闭时间均短于改良Hardinge组,前者分别为(67.4±9.5)min和(12.9±2.7)min,后者分别为(71.9±5.1)min和(25.0±3.8)min。SuperPATH组术后1、5 d血红蛋白(Hb)分别下降(12.6±3.7)g/L和(15.2±3.8)g/L,下降值低于改良Hardinge组,后者分别为(16.9±4.5)g/L和(21.0±5.3)g/L。SuperPATH组术后6周内疼痛程度轻于改良Hardinge组,但术后3、6个月两组疼痛差异无统计学意义;SuperPATH组术后3个月Harris髋关节评分明显优于改良Hardinge组,分别为(70.4±4.8)分和(61.9±7.1)分,但两组术后6个月Harris髋关节评分差异无统计学意义;SuperPATH组患者满意度均优于改良Hardinge组。结论 SuperPATH入路髋关节置换术治疗高龄老年股骨颈骨折可获得良好的短期临床疗效。Objective To investigate the short-term clinical outcome of hip arthroplasty through the SuperPATH approach for femoralneck fractures in very elderly patients. Methods From August 2013 to October 2015,44 cases of hip arthroplasty, including total hip arthroplasty in 4 cases and femoral head replacement in 40 cases, through either the SuperPATH approach （21 cases） or the modified Hardinge approach （23 cases） for femoral neck fractures in patients aged 80 years or older were retrospectively reviewed. Among the 40 patientsundergoing hemrnrthroplasty, 20 cases through the SuperPATH approach and 20 cases through the modifiein terms of operation tme, blood loss, complications, pain visual analogue scale, Harris hip scores and patient satisfaction. Results Foroperation time, the SuperPATH groupwas averaged 67. 4±9. 5 min,whichwas less than themodfiedHardinge group that was averaged 71. 9±5. 1 min（_P〈0. 05）,and the surgical closure time of the SuperPATIIgroupwas on average 12. 9±2. 7 min,wmodified Hardinge group thatwas on average 25. 0±3. 8 min. The decline of heamoglobin on the 1 st postday from preoperative level in the SuperPATH group were 12. 6±3. 7 g/Land 15. 2±3. 8than those in themodfied Hardinge group thatwere 16. 9±4. 5 g/Land 21. 0±5. 3 g/L,respectively. Compared with group, the patients in the SuperPATH group suffered less pain within 6 weeks, similar pain in scores 70. 4±4. 8 in 3 months but similar scores in 6 months. The patients in the during the whole follow up period. Conclusion Through the SuperPATH approach, hip arthroplasty for patients showed favorable short-term effect.

关 键 词：股骨颈骨折 SuperPATH入路 改良HARDINGE入路 髋关节置换 微创手术 

分 类 号：R687.4[医药卫生—骨科学]