SuperPATH入路行人工股骨头置换术对老年骨质疏松性股骨颈骨折的影响  

Effect of artificial femoral head replacement on senile osteoporotic femoral neck fracture

作　　者：代国华[1] 殷勇[2] 季月英 弋石泉[1] DAI Guo-hua;YIN Yong;JI Yue-ying;YI Shi-quan(Department of Osteoporosis,Mianyang Orthopaedic Hospital,Mianyang,Sichuan621000,China;Department of Hip Joint,Mianyang Orthopaedic Hospital,Mianyang,Sichuan621000,China)

机构地区：[1]绵阳市骨科医院骨质疏松科,四川绵阳621000 [2]绵阳市骨科医院髋关节科,四川绵阳621000

出　　处：《创伤外科杂志》2019年第10期761-765,共5页Journal of Traumatic Surgery

基　　金：2017年绵阳市卫生计生委科研课题(201660)

摘　　要：目的探讨SuperPATH入路行人工股骨头置换术对老年骨质疏松性股骨颈骨折的影响。方法前瞻性选择2016年2月—2018年2月绵阳市骨科医院骨质疏松科和髋关节科收治的128例老年骨质疏松性股骨颈骨折患者,其中男性47例,女性81例;年龄65~80岁,平均70.1岁;致伤原因:摔伤116例,道路交通伤12例。随机数字表法分为对照组(67例)和观察组(61例);两组均行人工股骨头置换术,其中对照组采用传统后外侧入路,观察组采用SuperPATH入路。随访6个月,记录两组术中及术后各项指标,比较两组不同时间点的疼痛视觉模拟评分(VAS)、髋关节Harris评分及末次随访时欧洲五维健康量表(EQ-5D)指数评分等。结果观察组手术时间显著长于对照组,术中出血量、术后引流量均显著少于对照组,切口长度、下床行走时间、住院时间均明显短于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为8.20%,显著低于对照组的20.90%,差异有统计学意义(P<0.05);观察组术后1、2周VAS评分均显著低于对照组,术后1个月Harris评分均显著高于对照组,差异均有统计学意义(P<0.05);其他时间点VAS评分、Harris评分两组差异均无统计学意义(P>0.05);观察组末次随访时EQ-5D指数评分显著高于对照组,差异有统计学意义(P<0.05),在末次随访时髋臼外展角、前倾角上两组差异均无统计学意义(P>0.05)。结论SuperPATH入路与传统后外侧入路行人工股骨头置换术治疗老年骨质疏松性股骨颈骨折均安全有效,前者在减小手术创伤、提高安全性和促进术后康复上具有优势,有待进一步随访观察远期疗效。Objective To investigate the effect of SuperPATH approach on artificial femoral head replacement for senile osteoporotic femoral neck fracture.Methods A total of 128 elderly patients with osteoporotic femoral neck fractures were treated with osteoporosis and hip joints in Mianyang City Orthopaedic Hospital,including 47 males and 81 females;aged 65-80 years,mean 70.1 years old;there were 116 cases of falling injuries and 12 cases of road traffic injuries;they were randomly divided into control group(67 cases)and observation group(61 cases);both groups underwent artificial femoral head replacement,in which the control group used traditional posterolateral approach and the observation group used SuperPATH approach.They were followed up for 6 months,the intraoperative and postoperative indicators of the two groups were recorded,the pain visual analogue scale(VAS),hip Harris score and the European five-dimensional health scale at the last follow-up(EQ-5D)were compared.Results The operation time of the observation group was significantly longer than that of the control group,the intraoperative blood loss and postoperative drainage volume were significantly less than those of the control group.The length of the incision,the walking time of the bed,and the hospitalization time were significantly shorter than the control group,and the difference was statistically significant(P<0.05);the incidence of complications in the observation group was 8.20%,which was significantly lower than those in the control group(20.90%),and the difference was statistically significant(P<0.05);the VAS scores of the observation group were significantly lower than those of the control group at 1 week and 2 weeks after operation,the Harris score was significantly higher than that of the control group at 1 month after operation,and the differences were statistically significant(P<0.05);the VAS scores at other time points were observed and there was no significant difference in Harris score between the two groups(P>0.05);the EQ-5D index score was s

关 键 词：股骨颈骨折 置换术 骨质疏松 入路 老年 

分 类 号：R683.42[医药卫生—骨科学]