直接前入路与后外侧入路全髋关节置换术的近期临床效果对比  

Comparison of direct anterior approach and posterolateral approach in total hip arthroplasty:short-term clinical efficacy

作　　者：倪喆[1] 尚希福[1] 吴科荣[1] 唐国霖 罗正亮[1] 陈敏[1] NI Zhe;SHANG Xifu;WU Kerong;TANG Guolin;LUO Zhengliang;CHEN Min(Department of Joint Surgery,Anhui Provincial Hospital,Hefei 230001,China)

机构地区：[1]安徽省立医院骨科关节外科,合肥230001

出　　处：《中华骨与关节外科杂志》2018年第7期518-521,共4页Chinese Journal of Bone and Joint Surgery

基　　金：安徽省自然科学基金(1808085QH242)

摘　　要：背景:全髋关节置换术(THA)已经成为关节外科近年来最成功的手术之一。随着手术技术的进步,人们希望能找到一种更符合快速康复(ERAS)要求的手术方式。直接前方入路THA成为一种热门的选择。目的:探讨直接前方入路与后外侧入路THA近期临床效果的差异。方法:按时间顺序,依次抽取2015年6月至2016年12月分别采用直接前方入路和后外侧入路行THA的两组病历资料,每组100例。所有患者均随访1个月,观察两组患者的手术时间、术中出血量、切口长度、下床活动时间和住院时间、术后髋臼前倾角、髋臼外展角、平均髋臼假体直径、术后1个月Harris髋关节功能评分、并发症发生率及术后1个月的生活质量情况。结果:两组患者的切口长度、Harris髋关节功能评分、髋臼外展角、髋臼前倾角、平均假体直径及并发症发生率相比,差异均无统计学意义(P>0.05);直接前方入路组患者的手术时间、术中出血量、下床活动时间和住院时间显著短(少)于后外侧入路组(P<0.05);直接前方入路组患者术后生活质量评定量表8个维度的评分均显著高于后外侧入路组(P<0.05)。结论:直接前方入路THA与后外侧入路THA相比,可以明显缩短患者的手术时间、下床活动时间和住院时间,对于提高患者生活质量具有重要意义。Background：Total hip arthroplasty（THA） has become one of the most successful operations in joint surgery in recent years.With the progress of surgical technology,people want to find a more suitable surgical method for enhanced recovery after surgery（ERAS）.Direct anterior approach（DAA） for THA has become a popular choice.Objective：To explore the short-term efficacy of DAA and posterolateral approach in THA.Methods：Two hundred patients scheduled for THA from June 2015 to December 2016 were selected as objects of the study.During THA,DAA was used in 100 patients（observation group）,and posterolateral approach was applied in the other 100 patients（control group）.All the patients were followed up for one month.The operation time,intraoperative blood loss,length of incision,time and length of hospital stay,anteversion angle of acetabulum,abduction angle of acetabulum,acetabulum prosthesis on average diameter,Harris hip score,complication rates,and the quality of life were compared between the two groups.Results：There was no significant difference in incision length,Harris score,anteversion angle of acetabulum,abduction angle of acetabulum,acetabulum prosthesis on average diameter or incidence of complications between groups（P〉0.05）.The operation time,amount of bleeding,ambulation time and hospitalization time in observation group were significantly shorter（less） than those in control group（P〈0.05）.The SF-36 score in observation group was significantly higher than that in control group（P〈0.05）.Conclusions：Compared with posterolateral approach,direct anterior approach can significantly shorten operation time,bed activity time and hospitalization time,and improve the quality of life of patients undergoing THA.

关 键 词：直接前方入路 后外侧入路 全髋关节置换 生活质量 临床效果 

分 类 号：R687.4[医药卫生—骨科学]