SuperPATH微创入路人工股骨头置换术治疗老年股骨颈骨折的短期随访研究  

Short-term follow-up study of superpath minimally invasive approach in artificial femoral head replacement for senile femoral neck fractures

作　　者：徐果飞 胡力[1] 杨书华 XU Guo-fei;HU Li;YANG Shu-hua(Department of Orthopedics,Chongzhou People＇s Hospital,Chengdu 611230,Sichuan,CHINA;Department of Orthopedics,Orthopedics Hospital of Sichuan Province,Chengdu 610000,Sichuan,CHINA)

机构地区：[1]崇州市人民医院骨科,四川成都611230 [2]四川省骨科医院,四川成都610000

出　　处：《海南医学》2018年第17期2400-2404,共5页Hainan Medical Journal

基　　金：四川省卫生和计划生育委员会科研项目(编号:20150129)

摘　　要：目的探讨SuperPATH微创入路人工股骨头置换术治疗老年股骨颈骨折患者的临床效果。方法选取崇州市人民医院骨科2016年2月至2017年10月收治的老年股骨颈骨折患者92例,按随机数表法分为对照组和观察组,每组46例。对照组采取常规入路人工股骨头置换术,观察组采取SuperPATH微创入路人工股骨头置换术。统计两组患者的手术情况(切口长度、手术时间、术中失血量、术后引流量)、术后恢复情况(下床活动时间、完全负重时间、住院时间)、术前及术后6个月髋关节功能(Harris)评分、术前及术后3个月生活质量(SF-36)分值和并发症发生率。结果观察组患者的手术时间为(118.76±14.33)min,明显长于对照组的(69.54±11.08)min,但切口长度为(7.09±1.10)cm,明显短于对照组的(9.07±1.05)cm,差异均有统计学意义(P<0.05);观察组患者的术中失血量为(190.29±21.51)m L,术后引流量为(116.84±18.35)m L,少于对照组的(387.41±49.52)m L、(292.03±17.41)m L,差异均有统计学意义(P<0.05);观察组患者的下床活动时间(2.66±0.62)d、完全负重时间(11.27±2.76)d、住院时间(9.34±1.06)d,明显短于对照组的(8.51±4.57)d、(31.53±6.40)d、(14.44±2.12)d,差异均有统计学意义(P<0.05);术后6个月,两组患者的关节活动度、功能、行走、疼痛分值较术前增高,且观察组关节活动度(4.91±0.03)分、功能(16.52±0.97)分、行走(31.02±1.78)分、疼痛(42.97±2.96)分,明显高于对照组的(4.04±0.10)分、(13.07±1.02)分、(27.20±1.56)分、(37.86±2.51)分,差异均有统计学意义(P<0.05);术后3个月,两组患者的SF-36分值较术前增高,且观察组患者的SF-36分值为(86.66±8.57)分,明显高于对照组的(78.78±9.11)分,差异有统计学意义(P<0.05);观察组患者的并发症发生率为6.52%,明显低于对照组的21.74%,差异有统计学意义(P<0.05)。结论采取SuperPATH微创入路人工股骨头置换术治疗老年股骨颈骨折可减少手术创�Objective To explore the clinical effect of artificial femoral head replacement by SuperPATH minimally invasive approach for elderly patients with femoral neck fractures. Methods A total of 92 patients with femoral neck fractures treated Chongzhou People＇s Hospital were selected from February 2016 to October 2017. According to the random number table, they were randomly divided into control group and observation group, with 46 patients in each group. The control group received conventional femoral head replacement, and the observation group received artificial femoral head replacement by SuperPATH minimally invasive approach. The operative condition（length of incision, duration of operation, blood loss during operation, postoperative drainage）, postoperative recovery（bed-off activity time, full weight bearing time, length of hospital stay）, hip function（Harris） score before and 6 months after operation, quality of life（SF-36） score before and 3 months after operation, and incidence of complications between the two groups were compared. Results The duration of operation in the observation group was（118.76±14.33） min, which was significantly longer than（69.54±11.08） min of the control group, but the length of the incision was（7.09±1.10） cm, which was significantly shorter than（9.07 ± 1.05） cm of the control group（P〈0.05）. The intraoperative blood loss and postoperative drainage of the patients in the observation group was（190.29 ± 21.51） m L,（116.84 ± 18.35） m L, which was less than（387.41±49.52） m L,（292.03±17.41） m L of the control group（P〈0.05）. The bed-off activity time, full weight-bearing time,and length of hospital stay was（2.66±0.62） d,（11.27±2.76） d,（9.34＋1.06） d in the observation group, which were significantly shorter than（8.51±4.57） d,（31.53±6.40） d,（14.44±2.12） d in the control group（P〈0.05）. Six months after operation, the scores of joint activity, function, walking and pain in the two groups we

关 键 词：SuperPATH微创入路 人工股骨头置换术 股骨颈骨折 并发症 髋关节功能 预后 

分 类 号：R683.42[医药卫生—骨科学]