Bikini切口微创人工全髋关节置换术对老年股骨头坏死患者疗效及出血的影响  

Clinical efficacy of Bikini incision minimally invasive total hip arthroplasty on elder patients with femoral head necrosis and its effect on bleeding

作　　者：谷效斌 高虎方 朱广伟[1] 卢微波[1] 康波[1] 

机构地区：[1]河南省三门峡市中心医院骨科,472000

出　　处：《中国综合临床》2017年第10期918-922,共5页Clinical Medicine of China

摘　　要：目的 探讨Bikini切口微创人工全髋关节置换术对老年股骨头坏死患者疗效及出血的影响.方法 选取2015年1月至2016年12月我院收治的股骨头坏死老年患者76例,按照随机数字表法将患者分为研究组和对照组,每组各38例.研究组患者接受Bikini切口直接前入路微创人工全髋关节置换术,对照组接受前外侧入路人工全髋关节置换术.髋关节临床功能评价采用Harris和WOMAC评分.比较两组患者手术时间、切口长度、术中出血量、输血量、术后住院时间、术后72 h血红蛋白浓度、首次下床行走时间、双下肢长度差异以及并发症发生情况.结果 两组患者术后1、2、4个月各时间点Harris评分均较治疗前显著提高（P均〈0.05）,术后1、2、4个月各时间点WOMAC评分均较治疗前显著降低（P均〈0.05）,但两组间各时间点比较差异均无统计学意义（P均〉0.05）.研究组住院时间和首次下床行走时间显著短于对照组[住院时间：（6.1±2.8）、（7.9±3.2）d,P=0.011;首次下床行走时间：（5.3±1.5）、（6.4±1.7）d,P=0.004].治疗4个月后研究组双下肢长度差异小于对照组[（6.5±2.3）、（10.4±3.5）mm,t=5.740,P〈0.01].此外,手术时间、切口长度、并发症发生率、出血量、输血量两组比较差异均无统计学意义（P均〉0.05）.结论 Bikini切口微创人工全髋关节置换术治疗老年股骨头坏死患者疗效明显,不增加术中出血,术后关节功能恢复快,但远期效果仍需进一步观察随访.Objective To study the clinical efficacy of Bikini incision minimally invasive total hip arthroplasty on elder patients with femoral head necrosis and its effect on bleeding.Methods Seventy-six elder patients with femoral head necrosis in Sanmenxia Central Hospital from January 2015 to December 2016 were randomly divided into the study group（38 cases）and the control group（38 cases）.The patients in the study group were treated with Bikini incision minimally invasive total hip arthroplasty by anterior approach,while the control group underwent total hip arthroplasty by anterolateral approach.Harris score and WOMAC score were used to evaluate the clinical function of hip joint.The operation time,length of incision,intraoperative blood loss, blood transfusion,hospitalization time,hemoglobin level at 72 h after surgery,the first ambulation time,the lower limb length discrepancy,postoperative complication were recorded and compared between two groups.Results The Harris scores at 1,2,4 months after operation in the two groups were significantly improved（P〈0.05）, while WOMAC scores of patients at 1,2,4 months after operation were significantly lower than those before treatment（P〈0.05）.However,there were no significant differences at different time between the groups（P〉0.05）.The hospitalization time and the first ambulation time in the study group were significantly shorter than those in the control group（（6.1±2.8）d vs.（7.9±3.2）d,P=0.011;（5.3±1.5）d vs.（6.4±1.7）d,P=0.004）.After 4 months of treatment,the lower limb length discrepancy in the study group was less than that of the control group（（6.5 ± 2.3）mm vs.（10.4 ± 3.5）mm,P〈0.01）.In addition,there were no significant differences between two groups in the operation time,length of incision,complication occurrence,intraoperative blood loss and blood transfusion（P〉0.05）.Conclusion Treating femoral head necrosis with Bikini incision minimally invasive total hip arthroplasty can achieve favorable effectivene

关 键 词：股骨头坏死 人工全髋关节置换术 Bikini切口 前外侧入路 微创手术 . 

分 类 号：R687.4[医药卫生—骨科学]