SuperPATH和前外侧小切口入路THA的短期疗效比较  

Comparison of Clinical Efficacy of SuperPATH and Anterolateral Small Incision Approach in THA

作　　者：黄文文[1] 尹东[1] 黄宇[1] 黄晓[1] 石伟发 左德灵 王成龙 陈雄 Huang Wenwen;Yin Dong;Huang Yu(Department of Orthopaedics,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院骨科,广西南宁530021

出　　处：《实用骨科杂志》2018年第7期593-596,604,共5页Journal of Practical Orthopaedics

摘　　要：目的比较SuperPATH与前外侧小切口入路全髋关节置换术(total hip arthroplasty,THA)的短期临床疗效。方法 2015年2月至2017年2月纳入80例行全髋关节置换术的患者,40例行SuperPATH入路THA治疗(SuperPATH组),40例行前外侧小切口入路THA治疗(前外侧小切口组)。比较两组患者手术切口长度、手术时间、术中出血、术后引流以及住院时间;两组患者术前及术后1d、7d、1个月、3个月的视觉模拟评分(visual analogue scale,VAS)评分;两组患者术前、术后7d、1个月、3个月、6个月的髋关节功能Harris评分;两组患者术后前倾角、外展角测量值以及术后并发症。结果 SuperPATH组手术切口长度小于前外侧小切口组(P<0.05),SuperPATH组术中出血、术后引流及住院天数均少于前外侧小切口组,差异有统计学意义(P<0.05),而SuperPATH组手术时间长于前外侧小切口组(P<0.05),SuperPATH组术后1d、7dVAS优于前外侧小切口组(P<0.05),但两组术后1个月、3个月VAS差异无统计学意义(P>0.05)。SuperPATH组术后7d、1个月、3个月的髋关节功能优于前外侧小切口组,Harris评分差异有统计学意义(P<0.05);但两组术后6个月髋关节功能比较差异无统计学意义(P>0.05)。两组术后外展角、前倾角对比差异无统计学意义(P>0.05)。结论 SuperPATH入路与前外侧小切口入路THA术后短期内髋关节功能恢复好,但SuperPATH入路THA手术创伤小、早期关节功能好、术后恢复快,而远期疗效还需进一步随访及评估。Objective To compare the short-term clinical efficacy between the SuperPATH minimally invasive approach and the anterior lateral small incision.approach in total hip arthroplasty.Methods From Feb 2015 to Feb 2017,80 patients undrwent THA were involved.All cases were randomly divided into 2 groups.40 cases were treated by using SuperPATH approach as Super PATH group,while another 40 cases were treated by using anterolateral small incision approach as small incision group.The length of incision,operative time,intraoperative bleeding,postoperative drainage,hospitalization time,abduction angle and anteversion angle time were compared between the two groups.The visual pain analogue score（VAS）before operation and the VAS score of 1 day,days,1 month and 3 months after operation and the Harris score of hip function before operation,and in 7 days,1 month and 6 months after operation were compared between the two groups.Results In SuperPATH group,the incision length was smaller than that of the anterior lateral small incision group（P〈0.05）;The hemorrhage,postoperative drainage and hospitalization time in SuperPATH group were less than those in the anterior lateral small incision group,and the difference was statistically significant（P〈0.05）,but SuperPATH group had longer operation time than the small incision group（P〈0.05）.Compared with the small incision group,the patient in the SuperPATH suffered less pain within 1 day and 7 days（P〈0.05）,similar pain in1 month and 3 months（P〈0.05）.The SuperPATH group＇s Harris hip score was increased significantly than small incision group from 7 days,1 month and 3 months after surgery（P〈0.05）,However,there was no significant difference in hip function between the two groups from 6 months after surgery（P〈0.05）.And there was no significant difference of abduction angle and angle of anteversion between 2 groups.Conclusion Both SuperPATH approach and anterolateral small incision approach can obtain good hip function in THA,but Super PATH approa

关 键 词：全髋关节置换术 SuperPATH入路 前外侧小切口入路 微创 

分 类 号：R687.42[医药卫生—骨科学]