不同手术入路全髋关节置换术对髋臼发育不良的疗效对比研究  

Comparative Study of the Effects of Total Hip Arthroplasty in Different Surgical Approaches on Acetabular Dysplasia

作　　者：贾健[1] 成凯[1] JIA Jian;CHENG Kai(Linfen People’s Hospital,Linfen 041000,China)

机构地区：[1]山西省临汾市人民医院

出　　处：《中国医学创新》2019年第23期6-10,共5页Medical Innovation of China

摘　　要：目的:对比不同手术入路全髋关节置换术对髋臼发育不良的疗效.方法:选择2016年8月-2018年9月在本院行全髋关节置换术的髋臼发育不良患者62例,采用随机数字表法分为对照组与观察组,每组31例.两组均由同一组具有5年以上临床经验的医护人员在全麻下进行手术,对照组行常规后侧入路全髋关节置换术,观察组行直接前侧入路全髋关节置换术.对比两组临床疗效、炎性反应指标及髋臼假体位置.结果:观察组治疗总有效率(96.77%)与对照组(93.55%)比较,差异无统计学意义(P>0.05).术后两组C反应蛋白(CRP)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)及肌酸激酶(CK)水平均明显高于术前(P<0.05),且对照组CRP、IL-1、TNF-α及CK均高于观察组(P<0.05).两组髋臼前倾角与外展角比较,差异均无统计学意义(P>0.05).结论:直接前侧入路与常规后侧入路行全髋关节置换术对髋臼发育不良患者的疗效相当,且髋臼假体位置差别不大,但直接前侧入路全髋关节置换术能够减轻患者炎性反应.Objective:To compare the effects of total hip arthroplasty through different surgical approaches on acetabular dysplasia.Method:A total of 62 patients with acetabular dysplasia underwent total hip arthroplasty in our hospital from August 2016 to September 2018 were selected.They were divided into control group and observation group by random number table method,31 cases in each group.The two groups were operated under general anesthesia by the same group of medical staff with more than 5 years of clinical experience.The control group was treated with routine posterior approach total hip arthroplasty.The observation group was treated with direct anterior approach total hip arthroplasty.The clinical efficacy,inflammatory response index and acetabular prosthesis position were compared between the two groups.Result:The total effective rate of the observation group(96.77%) was compared with that of the control group(93.55%),the difference was not statistically significant(P>0.05). The levels of C-reactive protein(CRP),interleukin-1(IL-1),tumor necrosis factor-α(TNF-α)and creatine kinase(CK)in both groups after operation were significantly higher than those before operation(P<0.05), and the levels of CRP,IL-1,TNF-α and CK of the control group were higher than those of the observation group (P<0.05).There was no significant difference in acetabular anteversion angle and abduction angle between the two groups(P>0.05).Conclusion:The effect of direct anterior approach is comparable to that of the conventional posterior approach for total hip arthroplasty in patients with acetabular dysplasia and there is little difference in the position of acetabular prosthesis,but the direct anterior approach total hip arthroplasty can reduce the inflammatory response in patients.

关 键 词：手术入路 全髋关节置换术 髋臼发育不良 

分 类 号：R687.4[医药卫生—骨科学]