小切口后外侧入路全髋关节置换术与早期康复训练对老年股骨颈骨折患者髋关节功能的影响  

Clinical Research of Small Incision Posterolateral Approach Total Hip Arthroplasty and Early Rehabilitation in Treatment of Femoral Neck Fracture for Elderly Patients

作　　者：黄莹[1] 潘海涛[1] 刘超[1] 顾明[1] 姜田甜[1] 周伟[1] HUANG Ying PAN Hai-tao LIU Chao GU Ming JIANG Tian-tian ZHOU Wei(Nanjing General Hospital, Nanjing Military Command, Nanjing, Jiangsu, 210009, China)

机构地区：[1]南京总医院(南京军区南京总医院),江苏南京210009

出　　处：《现代生物医学进展》2016年第35期6885-6887,6897,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(8130030)

摘　　要：目的:探讨小切口后外侧入路全髋关节置换术与早期康复训练对老年股骨颈骨折患者髋关节功能的影响及其临床效果分析。方法:选取2013年5月-2016年5月在我院接受治疗的老年股骨颈骨折患者327例,根据手术方法不同,将患者分为小切口组(169)和常规切口组(158例),分别采用小切口后外侧入路全髋关节置换术和常规切口后外侧入路全髋关节置换术,同时配合早期康复训练。观察并比较两组患者的手术时间、术中出血量、住院时间、髋关节Harris评分、VAS及VRS疼痛评分、生活质量评分。结果:小切口组术中出血量、住院时间均少于常规切口组,差异均具有统计学意义(P<0.05);两组术后Harris评分均高于术前,且小切口组高于常规切口组,差异均具有统计学意义(P<0.05)。两组术后VAS及VRS评分均显著低于术前,且小切口组低于常规切口组,差异均具有统计学意义(P<0.05)。两组早期康复训练后生活质量评分均高于训练前,且小切口组高于常规切口组,差异均具有统计学意义(P<0.05)。结论:早期康复训练配合小切口后外侧入路髋关节置换术治疗老年股骨颈骨折的临床效果显著,具有创伤小、出血量少、髋关节恢复快等优点,值得临床推广应用。Objective： To investigate the effect of total hip replacement and early rehabilitation training on the hip joint function in elderly patients with femoral neck fracture and its clinical effect. Methods： 327 patients with femoral neck fracture who were treated in our hospital from May 2013 to May 2016 were selected and according to the different surgical methods, the patients were divided into the small incision group （169） that treated with small incision posterior lateral approach road total hip arthroplasty and early rehabilitation training, and the conventional incision group （158 cases） that treated with the conventional total hip replacement. Then the operation time, the blood loss, the hospitalization, the Harris score, the VAS score, the VRS score and the quality of life between the two groups were observed and compared. Results： The blood loss and hospitalization of the small incision group were less than those of the conventional incision group, and the differences were statistically significant （P〈0.05）; The Harris scores in the two groups after the operation were higher than before, and the small incision group was higher than that of the conventional incision group, and the differences were statistically significant （P〈0.05）. The VAS and VRS scores in the two groups after the operation were lower than before, and the small incision group was lower than that of the conventional incision group, and the differences were statistically significant （P〈0.05）. The quality of life in the two groups after the operation were higher than before, and the small incision group was higher than that of the conventional incision group, and the difference was statistically significant （P〈0.05）. Conclusion： Small incision posterolateral approach total hip arthroplasty and early rehabilitation has better clinical effects on the treatment of femoral neck fracture for elderly patients with the advantages of less trauma and blood loss, higher safety and better recovery, which is worthy

关 键 词：股骨颈骨折 小切口 全髋关节置换术 早期康复训练 

分 类 号：R683[医药卫生—骨科学]