SuperPATH微创入路人工股骨头置换术治疗高龄股骨颈骨折的早期疗效评价  

Early efficacy evaluation of SuperPATH minimally invasive artificial femoral head replacement for the treatment of femoral neck fracture in the elderly

作　　者：谢成[1] 朱成栋[2] 乔高山[2] 胡天胜 朱乐银[2] 黄华[2] 钱俊[2] 夏正荣[2] 顾英俊 Xie Cheng;Zhu Chengdong;Qiao Gaoshan;Hu Tiansheng;Zhu Leyin;Huang Hua;Qian Jun;Xia Zhengrong;Gu Yingjun(Department of Hip,Mianyang Orthopaedic Hospital,Mianyang Sichuan,62100;Department of Trauma and Orthopedics,The People′s Hospital of Yizheng(Affiliated Yizheng Hospital of Yangzhou UniversityMedical College),Yizheng Jiangsu,211400,China)

机构地区：[1]四川省绵阳市骨科医院髋关节科,四川绵阳621000 [2]仪征市人民医院(扬州大学医学院附属仪征医院)创伤骨科,江苏仪征211400

出　　处：《生物骨科材料与临床研究》2020年第1期63-66,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨SuperPATH微创入路人工股骨头置换术治疗高龄股骨颈骨折的早期疗效。方法回顾性分析2015年10月~2017年6月期间采用SuperPATH微创入路人工股骨头置换术治疗51例高龄股骨颈骨折患者资料。其中,男20例,女31例;左髋19例,右髋32例;平均年龄为(75.6±9.7)岁。观察切口长度、手术时间及并发症等方面情况。评价术前、术后3 d、6个月及12个月患髋Harris评分。结果51例患者均获12~18个月随访。手术切口长度(6.5±1.7)cm,手术时间(40.9±12.6)min,住院时间(6.5±1.8)d,术中出血量(138.7±30.5)m L,下地行走时间(1.6±0.8)d。随访期间无切口感染、DVT、关节脱位等严重并发症。术后3 d与术前患侧髋关节Harris评分[(67.3±6.3)分,(12.1±4.3)分]比较;术后6个月与术后3 d患侧髋关节Harris评分[(84.7±4.5)分,(67.3±6.3)分]比较,差异均有统计学意义(P<0.05)。结论SuperPATH微创入路人工股骨头置换术治疗高龄股骨颈骨折能有效改善髋关节功能,早期疗效明显;不仅具有创伤小、疼痛轻、患者满意度高等优点,还能降低术后关节脱位等风险。Objective To explore the early efficacy of SuperPATH minimally invasive approach for artificial femoral head replacement in the treatment of femoral neck fractures in the elderly. Methods From October 2015 to June 2017, SuperPATH minimally invasive surgery for artificial femoral head replacement in the treatment of 51 cases of femoral neck fracture in the elderly. There were 20 males and 31 females;left hip in 19 cases and right hip in 32 cases;the mean age was(75.6± 9.7) years. The length of the incision, the operation time and complications were observed. The hip Harris score was used to assess the function of the hip before surgery and 3 days, 6 months and 12 months after surgery. Results All 51 patients were followed up for 12 to 18 months. The length of the incision was(6.5 ±1.7) cm, the operation time was(40.9±12.6) min, the time of hospitalization was(6.5±1.8) d, the intraoperative blood loss was(138.7±30.5)mL, the walking time was(1.6±0.8) d. No complications such as incision infection, DVT, prosthesis dislocation in the follow-up period. The hip score of 3 days after operation and before the operation were [(67.3±6.3) points,(12.1±4.3)points];the hip score of the affected hip 6 months after operation and 3 days after operation were [(84.7±4.5) points,(67.3±6.3) points], the differences were statistically significant(P<0.05). Conclusion The SuperPATH minimally invasive approach for artificial femoral head replacement for the treatment of advanced femoral neck fractures can effectively improve hip function. Early curative effect is obvious;not only has the advantages of small trauma, light pain,high patient satisfaction, but also reduces the risk of postoperative joint dislocation.

关 键 词：SuperPATH入路 关节成形术 置换 髋 微创 小切口 股骨颈骨折 

分 类 号：R683.42[医药卫生—骨科学]