直接前侧入路和前外侧入路在全髋关节置换中的疗效对比  

Comparison on the Effect of Direct Anterior Approach and Anterolateral Approach in the Patients with Total Hip Replacement

作　　者：方浩伟[1] 陈凯宁[1] 李振宇[1] 陈志云[1] FANG Haowei;CHEN Kaining;LI Zhenyu;CHEN Zhiyun(The People’s Hospital of Puning City,Puning 515300,China)

机构地区：[1]广东省普宁市人民医院,广东普宁515300

出　　处：《中国医学创新》2020年第2期49-52,共4页Medical Innovation of China

基　　金：2019年揭阳市卫生健康局医学科学技术研究立项项目和推广应用新技术新项目(揭市卫[2019]66号)。

摘　　要：目的:观察与比较直接前侧入路和前外侧入路在全髋关节置换中的疗效。方法:选取2014年6月-2019年4月本院收治的76例全髋关节置换患者为研究对象,依据治疗方式的不同分为A组(直接前侧入路)和B组(前外侧入路),各38例。比较两组手术前后的颈干角、前倾角、髋臼前倾角及外展角、疼痛程度,以及术后Harris髋关节功能评分情况、并发症发生率、下床活动时间及住院时间。结果:术后1、3个月,A组的Harris髋关节功能评分优良率均高于B组,差异均有统计学意义(字2=5.278、4.828,P=0.021、0.028);术后6个月,两组的Harris髋关节功能评分优良率比较,差异无统计学意义(字2=1.056,P=0.304)。两组患者手术前后的颈干角、前倾角、髋臼前倾角及外展角比较,差异均无统计学意义(P>0.05);但两组术后1 d和1周的前倾角均低于术前,差异均有统计学意义(P<0.05)。术后3、14 d,A组的疼痛程度均优于B组,差异均有统计学意义(P<0.05)。A组的并发症发生率低于B组,下床活动时间及住院时间均短于B组,差异均有统计学意义(P<0.05)。结论:直接前侧入路在全髋关节置换中的早期疗效优于前外侧入路,因此应用价值相对更高。Objective: To observe and compare the effect of direct anterior approach and anterolateral approach in the patients with total hip replacement. Method: A total of 76 patients with total hip replacement from June 2014 to April 2019 were chosen as the study objects, and they were divided into group A(direct anterior approach) and group B(anterolateral approach), 38 cases in each group, according to the differences of treatment methods. Then the cervical trunk angle, anteversion angle, acetabular anteversion angle and abduction angle and the degree of pain before and after the operation, Harris score after the operation, complications rates, out-of-bed activity time and hospitalization time of two groups were compared. Result: 1 month and 3 months after surgery, the excellent and good rate of Harris hip joint function score in group A were higher than those in group B, with statistically significant differences( 字2=5.278, 4.828, P=0.021, 0.028);6 months after the operation, there was no significant difference between the two groups in the excellent and good rate of Harris hip joint function score( 字2=1.056, P=0.304). There were no statistically significant differences between the two groups in cervical and trunk angle, anterior inclination, acetabular anterior inclination and abductor angle before and after surgery(P>0.05);however, the rake angle of the two groups 1 day and 1 week after operation were lower than those before operation, the differences were statistically significant(P<0.05). 3 and 14 days after surgery, the pain degree of group A were better than those of group B, with statistically significant differences(P<0.05). The complication rate of group A was lower than that of group B, and the time of out-of-bed activity and hospital stay were shorter than those of group B, with statistically significant differences(P<0.05). Conclusion: The early effect of direct anterior approach in the patients with total hip replacement is better than that of anterolateral approach, and its application value is relat

关 键 词：直接前侧入路 前外侧入路 全髋关节置换 

分 类 号：R687.4[医药卫生—骨科学]